1: Insurance Coverage and Hyperbaric Oxygen Therapy Costs

A common question regarding hyperbaric oxygen therapy costs is whether insurance will cover the treatment. For many medically recognized conditions, the answer is yes. Hyperbaric oxygen therapy costs can often be offset by Medicare and other health insurance policies if the treatment is deemed medically necessary. However, getting this coverage typically requires prior authorization.

Conditions that are generally covered, which may reduce your out-of-pocket hyperbaric oxygen therapy costs, include:

1. Acute Peripheral Arterial Insufficiency for Diabetics – A condition where there is insufficient blood flow to the limbs, particularly concerning for diabetic patients due to their susceptibility to circulation issues.
2. Acute Traumatic Peripheral Ischemia – Loss of blood flow to a limb, often caused by traumatic injury, that can result in tissue damage and loss if not treated promptly.
3. Actinomycosis – A bacterial infection that causes long-term inflammation, typically affecting the face and neck, caused by the bacterium Actinomyces.
4. Air or Gas Embolism – The presence of air or gas bubbles in the bloodstream, which can obstruct vascular flow and cause severe complications such as organ damage.
5. Carbon Monoxide Poisoning – Exposure to carbon monoxide gas, which can prevent the blood from carrying oxygen to cells, tissues, and organs.
6. Chronic Refractory Osteomyelitis – A severe, persistent infection of the bone that fails to respond to conventional treatment.
7. Cyanide Poisoning – Exposure to cyanide, a highly toxic chemical that prevents cells from using oxygen, potentially causing rapid organ failure and death.
8. Decompression Sickness – A condition arising from reduced environmental pressure, leading to formation of gas bubbles in tissues, commonly known as “the bends.”
9. Diabetic Wounds of the Lower Extremities – Wounds typically found on the legs or feet of diabetic patients that heal poorly due to the effects of diabetes on circulation and immune function.
10. Exceptional Blood Loss – Severe bleeding that can lead to shock and requires immediate medical intervention.
11. Gas Gangrene – A deadly form of tissue death caused by bacteria that produce gas within tissues; often occurs after an injury or surgery.
12. Idiopathic Sudden Sensorineural Hearing Loss – Rapid, unexplained loss of hearing, typically in one ear, caused by damage to the sensory cells or nerve fibers in the inner ear.
13. Intracranial Abscess – A collection of pus inside the skull due to an infection, which can lead to increased pressure on the brain and severe health complications.
14. Necrotizing Fasciitis – A rapidly spreading bacterial infection that destroys skin, fat, and tissue covering the muscles.
15. Osteoradionecrosis – The death of bone tissue due to radiation exposure, typically following treatment for cancer.
16. Soft Tissue Radionecrosis – The breakdown of soft tissue as a result of radiation therapy, often seen in cancer treatment settings.
17. Thermal Burns – Burns caused by exposure to heat, such as fire, steam, hot liquids, or other heat sources, resulting in skin and tissue damage.

The specifics of how much hyperbaric oxygen therapy costs after insurance depends on your plan’s deductible, copay, and coinsurance requirements.

Can insurance help with hyperbaric oxygen therapy costs that are not on the list above.

2: Hyperbaric Oxygen Therapy Costs for Off-Label Uses

Beyond approved conditions, many insurers will not cover hyperbaric oxygen therapy costs for off-label uses even if they are consider the medically necessary. Some of these off-label conditions are listed below and are considered not yet approved by FDA, even though many studies show significant Improvement with HBOT.  Please note, we do carry very competitive rates and can be quite affordable as an out of pocket expense.

1. Addiction – A chronic condition characterized by compulsive or uncontrollable pursuit of substance use or certain behaviors despite adverse consequences.
2. Anoxic Brain Injury – Damage to the brain due to a lack of oxygen, which can lead to various neurological impairments.
3. Autism – A developmental disorder characterized by challenges with social interaction, communication, and repetitive behaviors.
4. Avascular Necrosis – The death of bone tissue due to a lack of blood supply, often leading to pain and joint problems.
5. Cerebral Palsy – A group of disorders affecting movement and muscle tone or posture caused by damage to the immature, developing brain, most often before birth.
6. Circulatory Disorders – A range of conditions that affect the circulatory system and can lead to decreased blood flow to various parts of the body.
7. Complex Regional Pain Syndrome – A chronic pain condition typically affecting a limb after injury, surgery, stroke, or heart attack, characterized by severe pain, swelling, and changes in the skin.
8. Concussion – A type of traumatic brain injury caused by a bump, blow, or jolt to the head, leading to temporary impairment of brain function.
9. Crohn’s Disease – A chronic inflammatory bowel disease that affects the lining of the digestive tract, causing severe diarrhea, pain, fatigue, and weight loss.
10. Fibromyalgia – A chronic condition characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues.
11. Long Covid – A range of symptoms that continue for months after recovery from COVID-19, including fatigue, shortness of breath, and cognitive issues.
12. Lyme Disease – An infectious disease caused by the Borrelia bacterium, spread by ticks, characterized by fever, headache, fatigue, and a skin rash.
13. Migraines – A neurological condition that causes intense, debilitating headaches, often accompanied by nausea, vomiting, and sensitivity to light and sound.
14. Multiple Sclerosis – A disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.
15. Near Drowning – Survival after suffocation caused by submersion in liquid, which can lead to serious secondary complications.
16. PTSD (Post-Traumatic Stress Disorder) – A psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event.
17. Recovery from Plastic Surgery – The healing process following cosmetic or reconstructive surgery, which can involve managing pain and preventing infection.
18. Sports Injuries – Injuries resulting from athletic activities that can range from sprains and strains to fractures and tears.
19. Stroke – A condition where the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.
20. Traumatic Brain Injuries – Injuries to the brain caused by an external mechanical force, potentially leading to temporary or permanent impairment of cognitive, physical, and psychosocial functions.

Insurers like BlueCross BlueShield, United Healthcare, Cigna, and Humana on rare occasions do consider “off-label” hyperbaric oxygen therapy costs eligible for coverage under specific circumstances. However, we recommend you get pre-approved with them for your specific indication before you assume it will be covered.  You will need to provide your insurance carrier with your specific diagnosis codes to see if you are eligible. 

3: Managing Out-of-Pocket Hyperbaric Oxygen Therapy Costs

When treatments are not covered by insurance, patients must manage the full hyperbaric oxygen therapy cost on their own. The out-of-pocket hyperbaric oxygen therapy cost largely depends on the prescribed number of treatments, determined by a specialist in hyperbaric medicine or the referring physician.

Supporting Your Financial Planning for Hyperbaric Oxygen Therapy Costs

At Hyperbaric Centers of Florida, we focus on ensuring our patients can manage their hyperbaric oxygen therapy costs effectively.  We offer competitive pricing and special discounts for two persons in our Multiplace Chamber.

Interested in more details on hyperbaric oxygen therapy costs or need guidance on payment options?

Contact us today for personalized assistance and expert advice on managing the costs associated with hyperbaric oxygen therapy.