(Disclaimer: I know the SDMB is not a substitute for seeing a doctor.)
I have a bump (for lack of a better word) on my neck. I know it’s not a malignity or any such thing. It’s pretty much a lump of scar tissue from a place where I cut myself a long time ago and haven’t been able to keep from picking at. (This blows my mind; I make up my mind not to touch it, and then later I discover that I have messed with it again. It’s like my hand is possessed and does stuff if I don’t keep my eyes on it.)
Anyway, it gets on my nerves and I’d like to have it removed. would it be better to see a cosmetic surgeon for this sort of thing, or would my family doctor be a good choice? I don’t know what the HMO/insurance implications might be; it might be that it would be covered if I went to my GP but not if I went to a cosmetic doctor.
Go see a GP/FP and ask for a dermatologist referral. Then you don’t have to worry about whether your consultation will be covered. For minor procedures like removing a small scar, mole, or whatever you definitely won’t need a cosmetic surgeon. The dermatologist should be able to knock it out in 10 minutes, and you’ll only need a local.
The chief advantage of going to a plastic surgeon is that you are more likely to have a better cosmetic result. For some spots on the body a scar is not much of an issue, particularly if it would normally be covered by clothes, but scars on the face and neck are more problematic.
A dermatologist is another good choice, and if it’s beyond his/her skill they would likely refer you to a plastic/reconstructive surgeon. Alternatively, you might wind up with an ear, nose, and throat specialist. A lot depends on where, exactly, this lump is and proximity to vital structures like nerves and blood vessels.
As for coverage - no matter who you go to, GP, dermatologist, or plastic surgeon, if the removal of this lump is not medically necessary your insurance may (nay, likely) won’t cover any of the removal. Part of consulting with a doctor will be determining if there is a medical justification for its removal. If there is, then more than likely your insurance will cover it, and might even cover the plastic surgeon. Only doctors/your insurance company can make that determination, and certainly not on a message board. When I had to have surgery on my face a number of years ago the insurance company approved a plastic/reconstructive surgeon because of where the incision had to be located - a misstep would have had consequences potentially far worse than a disfiguring scar so using an expert was a logical choice, so logical even the insurance company went with it without question. Needless to say, your mileage may vary.
If it’s not medically necessary then it’s considered cosmetic. There’s nothing wrong with that, but you will wind up paying for all of it yourself. Either you would need to save up for it, take out a loan, or arrange a payment plan with the doctor who performs the procedure. This would also be something to discuss with the doctor(s), and if it really bothers you, you might find the expense to be worth the cost. I do caution, however, that surgery, even minor surgery, is not a place to get cheap. You’d do better to either hold off and save up a bit more money, or opt for a longer period of payment, and go with a well-researched doctor you feel comfortable with than simply making a determination based solely on lowest price.
Do you have an insurance agent? It’s an easy answer as to when that sort of thing is or isn’t a covered expense - just a few questions (that I wouldn’t ask, nor hope you’d answer, on an open message board) that a competent agent would know.
Haha, I flatter myself by thinking I’m one. I actually know an excellent agent in Tampa if you truly need one.
While we all go under the same title, some of us are more “insurance salesmen” and some are more “insurance consultants.” I’d hope that my clients see me as the latter more than the former.
As to the OP, if you’re on an HMO then I would recommend seeing your GP before anything else - HMO’s love to see a paper trail that leads back to a primary physician. HMO’s pay their participating doctor’s differently than doctors operating under, say, a PPO or a POS (point of service, not…yeah) and the structure makes it much more important for them to sort of keep treatment “in the family.”
