Is Osteoma Removal Covered By Insurance?

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Osteomas, along with lipomas and cysts, are common complaints to have removed from the face and neck area. They can cause discomfort and sometimes even pain for the person experiencing them. 

Is Osteoma Removal Covered By Insurance

For someone who is living with this issue, they may want to have it removed but could be worried about the cost of doing it and whether their insurance covers it. Medical procedures can add up very quickly, so for those who don’t have insurance it could mean the difference between seeking medical attention and not. 

Having an osteoma removed could be covered by private insurance, depending on your policy type and coverage, but it can also – in some cases – be covered by Medicare. Here’s what you need to know about this condition and having insurance cover the costs

What Is An Osteoma?

An osteoma is a boney growth that is typically non-cancerous and appears as a hard knot, in a fixed location, on someone’s forehead or scalp usually. Sometimes they can develop in someone’s sinuses, though too. 

This will feel like a hard bump that doesn’t move when you touch it. The size of the bump will depend on the person, as they grow at different rates and people may or may not notice it as easily. A person will be able to move the skin overtop of the bump but the bump itself won’t move around. 

While this condition can happen at any time in a person’s life, but they are most commonly found in people who are between 20 and 40 years old. Additionally, it is most common for people to only have one osteoma but there are some reported cases of multiple osteomas on one person at the same time. 

Osteoma’s usually don’t get infected or drain into cavities in forehead, nor do they contribute to the change of someone’s skin overtime. Additionally, there has not been one cause cited for osteoma’s happening. A few theories include genetics and trauma to the area, where the growth formed as they body’s response. 

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Does An Osteoma Hurt?

Most people who have had this condition report that they do not feel any physical pain or discomfort from having it. However, it does alter a person’s appearance and can really make someone feel self-conscious about their looks.

The majority of cases of people who have the removed are for cosmetic reasons. 

How Is An Osteoma Treated?

When you have an osteoma and you meet with a doctor to have it removed, they should go through the entire process with you and make sure you understand what is going to happen. 

man with stitch on forehead

Most removal procedures can be done in a doctor’s office or clinical setting. In some cases, depending on the size and complexity, the removal will be done in an operating room under general anesthesia. 

The doctor will numb the area around the osteoma first to make sure that you don’t feel anything during the procedure. If the removal is being done in an operating room then you will be asleep during the procedure and will wakeup when it’s finished. 

The doctor will then make an incision, usually along the hairline or right above the osteoma – depending on the location. Next, the doctor will shave down the growth (as it is bone). The doctor will continue to shave down the growth until it is flush with the surrounding bone of the face, and it completely gone. 

The doctor will then close the incision for the best cosmetic healed look. The doctor will hide the scar in your hairline or in the natural expression of your face so that it’s not obvious and you may not even notice it when it’s completely healed. 

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Getting An Osteoma Removal Covered By Insurance

Many people report that their private or extended benefits do not cover an osteoma removal. 

The reason behind this is that it is usually considered a cosmetic procedure, and it’s not life threatening to the person who has it. 

Doctors will report that osteomas do not hurt the person who has it, but it can make people feel very uncomfortable with their appearance when they have them. 

So having an osteoma removed and covered by insurance, you may need to try it a few times and get your doctor involved. You will likely need to prove that you need to have it done and your life is otherwise compromised if you don’t. 

Overall, if your doctor can confirm the removal is not purely for cosmetic reasons or to enhance your appearance, most insurance companies will be able to approve at least a portion of the costs to have it done. 

Regardless of whether the procedure is covered, any medications or post-procedure instructions will likely be covered under your regular drug benefit plan. 

Although if you have questions about something specific to your coverage you can always reach out to your benefit provided to ensure you get the most up to date information and know what your out of pocket expenses are likely to be. 

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Is Osteoma Removal Covered By Medicare?

When you’re on Medicare, you may be covered for certain procedures that you weren’t aware of. When it comes to plastic/cosmetic surgeries, Medicare is usually a little hesitant to automatically cover the cost because it’s not impacting the person’s life in a way that is painful or causing them severe discomfort. 

forehead bump

There are some ways around this in that your doctor may be able to advocate for you and get involved so that Medicare can at least help with some of the cost.

In general, if the osteoma is not causing you pain and discomfort then you will probably have a hard time getting it covered by Medicare. 

For specific information on your coverage and what you may be able to get help with you should contact Medicare (or your direct case worker) to determine if this procedure is an option for you. 


Why Get An Osteoma Removal?

If the osteoma is not causing you any pain or discomfort you may consider not having it removed because it’s really not impacting your life. 

It will alter your appearance, though, and you may feel like people are always looking at it or asking you what it is. This can make almost any uncomfortable, so it might make you feel a little better to have it removed and that way people are not always looking at it. 

In addition to that, when the osteoma is removed your doctor will sent a part of it to the lab for analysis. When the pathology is done, it can be confirmed that the mass is not cancerous and there is no reason to be concerned. Even though the majority of osteomas are benign, it doesn’t mean that’s always the case. It can give patients a lot of relief knowing that they don’t have anything else to worry about once it’s removed. 

Further, this is a procedure/surgery that has very minimal downtime and the recovery is very quick. This means you don’t have to take a lot of time off work or be unable to do things around the house for very long. 

The scar itself may take a little while to heal but you’ll be up and moving in no time and you likely won’t experience much pain after the procedure. Having this done sooner, rather than later, can make a huge difference in your life and give you back a lot of your confidence. 

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What Can You Experience After An Osteoma Removal Surgery?

Immediately after the procedure, the area around the osteoma will still be numb (probably for several hours) so you likely won’t feel anything right away. 

osteoma biopsy

As the numbness wears off, it will probably feel bruised and you’ll likely notice quite a bit of swelling in the area right after. There may be some discomfort, and your doctor will be able to provide you with instructions for which types of pain relief medication is safe for you to take

You may have a bandage or wound dressing on the area that needs to be looked at and changed occasionally. If this is the case, then your doctor will arrange for you to come back to the office or provide you with instructions on how to change the bandage yourself. 

Approximately 24 hours after the procedure you will be able to shower and bathe like you normally would. If you have stitches in the incision they are usually removed 7 – 10 days after the procedure, and you can return to your regular social activities within a week. If you took time off of work to have this procedure done, you likely don’t need to take more than a few days before returning to work. 

The cost to have an osteoma removed may not be totally covered by insurance, but you may be able to get it partially covered or have some of the medication costs covered. Before having any procedure done, it may be worth it to call your insurance first and make sure you will get the coverage you are expecting.