For insured patients, Mr Gault’s consultation fees and follow-up fees are usually covered by most insurance companies. In the case of fees for surgery, however, BUPA and Aviva members in particular should be aware that current reimbursement may be less than with other Insurers, and that there is usually a shortfall which is payable by the patient. Axa PPP members should be aware that the insurer does not pay for follow-up fees if the appointment falls within ten days of your surgery. There may also be an excess on your policy, or specific exclusions.
Surgery for aesthetic (cosmetic) reasons is usually excluded, and even for immediate reconstruction after the removal of cancers, there may be a shortfall on surgical fees, although hospital fees and histology fees (which usually are the biggest expense) are usually covered in full. Laser treatment to treat difficult ear cancers in combination with conventional surgery may also not be covered.
You will be asked to settle any shortfall and we strongly advise that you check that you have authorisation from your Insurer for the procedure you contemplate together with benefit maxima. Your insurer may ask you for a CCSD code to indicate to them the type of procedure you are considering, and we are always happy to help.
Ear reconstruction is now rarely covered by health insurance companies, even in cases of trauma or removal of the ear because of cancer.
We respectfully request that you settle the fees in full pre-operatively and request reimbursement from your Insurer, if applicable. For detailed information on the surgical procedures involved, we recommend that your insurance company advisors consult the following seminal texts by Mr Gault:
- Rib graft reconstruction vs Osseointegrated prosthesis for microtia: A significant change in patient preference. Gault DT Clinical Otolaryngology. 2001, 26, 274-277
- Reconstruction of the ear. Gault DT. A chapter for Principles and Practice of Head and Neck Oncology Editors Peter Rhys Evans, Patrick Gullane & Paul Montgomery. Martin Dunitz 2003 Winner of George Davey Howells Memorial Prize for most distinguished published contribution to the advancement of Otolaryngology during the preceding five years.
- Management of Congenital Deformities of The External And Middle Ear. Gault DT A chapter for Scott Brown's Otorhinolaryngology, 7th Edition Arnold 2007.
- Total Reconstruction of the Pinna - a chapter for Scott Brown's Otorhinolaryngology, Head and Neck Surgery, 7th Edition Arnold 2007