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Tonsil Removal Cost: How Insurance Affects the Price

Tonsil removals can restore your quality of life if you get sore throats often. But learn what you’ll expect to pay, both with and without insurance.

Last updated on

September 7, 2023

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Tonsil Removal Cost: How Insurance Affects the Price

Your tonsils are your immune system’s first line of defense against foreign invaders who might make you sick. However, this makes them particularly vulnerable to infections like strep throat. For some people, these illnesses can happen over and over again without much relief.

The good news is that you don’t necessarily need your tonsils, so they can be removed by a professional. Here is everything you need to know about tonsil removal, as well as how having insurance can affect the cost of your treatment.

What Are Tonsils?

Your tonsils are lymph nodes in the back of your mouth and the top part of your throat. They are a defense mechanism against foreign particles like bacteria and viruses, latching onto them before they enter your system.

Tonsils contain a lot of white blood cells, which can kill germs. While this makes them good for catching bacteria and viruses before they cause you immense harm, they are usually prone to becoming infected very often.

Tonsillitis is an infection of the tonsils, often resulting in redness, swelling, and a sore throat. Sometimes, this sore throat can be excruciatingly painful. After frequent, persistent infections, tonsils can become naturally large. This can create even more of a risk for infection and sore throat.

Why Is a Tonsil Removal Performed?

A tonsil removal, or a tonsillectomy, is a procedure in which the tonsils are taken out of the mouth. Some people have naturally large tonsils that are more prone to frequent infection, or an individual may have a predisposition to recurring, chronic, and severe tonsillitis that makes it very difficult to live with tonsils.

Tonsils might also be removed if you have sleep disorders related to difficulty breathing, such as sleep apnea. Most tonsillectomies are done in children since the immune function of the tonsils declines into adulthood, but sometimes this procedure is still done on adults.

What To Expect From a Tonsillectomy

Tonsil removals are usually done as an outpatient procedure, meaning you can’t typically get them done at a dentist’s office. Ear, nose, and throat specialists (ENTs) are who you’ll be seeing to get this procedure done.

Before your procedure, your provider will do a routine check just to make sure you are well enough to receive the surgery. They’ll then give you a list of instructions for what you can expect, as well as what you need to do before the procedure.

Your doctor might ask you not to eat anything before the scheduled surgery, as well as to stop taking certain medications. They might also ask you to arrange a ride home since you might not be able to operate machinery if they sedate you.

Once the procedure has begun, you’ll be given general anesthesia to keep you asleep and comfortable. You won’t feel any pain during the tonsil removal itself.

There are a few different methods that surgeons can use to remove your tonsils:

  • Steel dissection: The surgeon uses a scalpel, or surgical knife, to remove the tonsils. They’ll then use extreme heat with a cauterizer to stop the bleeding or sutures.
  • Electrocautery: This method only uses that cauterizer to remove the tonsils while eliminating bleeding at the same time.
  • Harmonic scalpel: This novel treatment uses ultrasonic vibrations to remove the tonsils and stop the bleeding at the same time.
  • Snare tonsillectomy: A surgical instrument called a snare is used to free your tonsils. This device has a thin wire loop at the end that can clamp off your tonsils once freed from the position. It helps reduce bleeding.

From start to finish, you can anticipate that your tonsillectomy will be over within 30 minutes.

Tonsil Removal Recovery

The procedure for a tonsil removal itself is quick and painless, but the recovery process is a bit of a different story. Tonsil removal can lead to some pretty considerable discomfort and pain, especially for the first few days after surgery. You can expect to have some discomfort for one to two weeks.

You might feel some nausea, vomiting for a few days, and pain in the ears, neck, or jaw. You might experience bad breath, mild fever, swelling of the tongue or throat, or the feeling of something being stuck in your throat.

You won’t be able to eat hard or tough foods during your recovery period because of the pain and the possibility of opening up any sutures. Bland foods that are easy to swallow, like broth, applesauce, or jello, are wonderful choices. This is also a brilliant time to load up on some ice cream.

Your ENT will prescribe you some medications to take to better tolerate the pain, but you can also take over-the-counter medications like Tylenol. During your recovery period, bed rest is essential because it gives your body the time it needs to heal up. Be sure to drink plenty of fluids to avoid dehydration.

Risks of a Tonsillectomy

As with any procedure, a tonsil removal has its share of possible risks. Swelling of the tongue after your procedure can cause difficulty breathing, especially in the first few hours after surgery. In rare cases, severe bleeding can occur during surgery and even during the healing process.

It should be noted that complications are rare. In most circumstances, the surgery goes off without a hitch, and once the recovery period is overcome, people can live more comfortable lives.

Benefits of a Tonsil Removal

The main benefit of tonsillectomies is that they remove the chances of tonsillitis. For people prone to sore throats from this infection often, this can significantly improve their quality of life. This also means fewer infections of the tonsils as a whole.

Tonsil removal can also improve your sleeping habits if your sleep was disrupted due to inflamed and infected tonsils. Tonsillectomies can resolve sleep-related issues like sleep apnea to give you a better night’s sleep. This has a positive domino effect on other aspects of your life, such as your mood and productivity.

Cost of Tonsil Removals

One of the main reasons that people are unable to get a tonsil removal is because of the cost of treatment. Tonsillectomies are surgical ordeals that require a lot of equipment and skill despite not taking much time to complete the procedure.

When you add up the average out-of-pocket cost for the elements of this procedure, you can expect to pay nearly $4,500. That’s extremely inaccessible for most people, making it difficult for some to find relief from their sore throats.

Insurance can cover some or most of the cost. Most insurers will cover the cost of a tonsillectomy as long as it’s medically necessary, which might require you to show some proof of recurring infections, strep throat, or sleep apnea.

In most cases, your dental insurance plan will cover the cost of a tonsillectomy because it is considered an oral surgery. However, the extent of coverage can vary drastically depending on a wide range of factors.

Dental Care Without Insurance

If you don’t have insurance or if you have poor coverage, you can still get the care you need! Flossy is a pay-as-you-go service where you only pay for the dental procedures you receive. Since we can save you up to 50% on the out-of-pocket costs associated, you might even save money compared to paying those monthly insurance premiums.

From routine cleanings to complicated oral surgeries, you can get trusted dental care from a talented network of dentists that are all vetted against a set of rigorous criteria. Flossy doesn’t charge monthly fees or annual dues, so you can relax, knowing the price you see is the price you pay.

Stop waiting to get the care you’ve wanted just because of the cost barrier. Find a dentist in your city today and find a reason to smile brighter.

Sore Throat Home Remedies

You might be able to save money on a tonsillectomy if you’re able to get some relief for your sore throat right from home. While these tips and tricks won’t heal any infections, they can help you get some relief — even during a recovery period from your tonsil removal.

First, try drinking some comforting beverages. Warm liquids like tea or broth can help soothe a raspy throat. On the flip side, cold treats like ice cream or popsicles can reduce swelling and soothe your sore throat, too. Lozenges can also have the same effect, especially those which contain menthol.

Dry air in your home can further irritate a sore throat. Regularly humidify the environment with cool air to help moisturize your throat and reduce inflammation. You can accomplish this by sitting in a steamy bathroom for a few minutes, too.

Saltwater can also reduce inflammation. Gargle with a warm saltwater rinse to get some instant relief from a sore throat, and then spit it out into the sink.

There are also some things that you’ll need to avoid, such as smoking or inhaling cleaning products. These can irritate your throat even further and cause more pain. Finally, rest up and try not to use your voice often, as this can irritate your tonsils and make you feel even more uncomfortable.

In Conclusion

Your tonsils are a first line of defense against bacteria and viruses entering your immune system. This also means that they are at risk of becoming infected frequently. When this happens, it can lead to immense pain and discomfort.

People with large tonsils may be prone to tonsillitis more often than others, and this could require a tonsil removal. Tonsillectomies are partial or full removals of the tonsils that are completed by ENTs through a variety of methods.

While tonsil removals are covered under most dental insurance plans, not everyone in America has dental coverage to begin with. And the out-of-pocket costs of tonsillectomies can be very difficult to pay.

Stop worrying about the cost of dental care and start getting the care you need with Flossy. Through our pay-as-you-go model, you’ll save up to 50% on the out-of-pocket costs of routine care, and you’ll only ever pay for the services you receive.

Find a dentist and get started today with the Flossy App with no waiting period to access care.

Sources:

Tonsillitis - Illnesses & conditions | NHS inform

Tonsillectomy | Mayo Clinic

Tonsillectomy: Procedure Details and Recovery | Cleveland Clinic

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