Toenail fungus, also known as onychomycosis, is a common condition that affects the appearance and health of your toenails. The fungus can cause your nails to become discolored, thick, and even brittle. It can be unpleasant to look at, and in some cases, it can even be painful.
One of the newer treatment options available today is laser therapy. Laser treatment for toenail fungus offers a potentially faster and more effective solution compared to traditional methods like topical creams and oral medications.
But here’s the big question everyone asks: Does insurance cover laser toenail fungus treatment? The answer isn’t always straightforward, and it depends on several factors.
Toenail Fungus: Causes, Symptoms, and Diagnosis
Toenail fungus is an infection that can cause some pretty unpleasant symptoms. But how do you get it, and what does it look like?
Causes and Risk Factors
Fungi, like dermatophytes, yeasts, and molds, are often the culprits behind toenail fungus. You’re more likely to get it as you age, if you don’t keep your feet clean and dry, or if you’ve injured a toenail.
Toenail fungus is also contagious, so it can spread from person to person. Athlete’s foot (tinea pedis) is a related condition that can also lead to toenail fungus.
Recognizing the Symptoms
The symptoms of toenail fungus are pretty easy to spot. Your toenails might turn yellow, brown, or even whitish. They can also get thick and distorted, and they might become brittle and start to crumble.
How Toenail Fungus is Diagnosed
If you think you have toenail fungus, a doctor can usually diagnose it just by looking at your toes. To be sure, they might take a clipping of your toenail and send it to a lab for testing.
Treatment Options for Toenail Fungus
If you’re dealing with toenail fungus, you have a few treatment choices. Let’s take a look.
Traditional Treatments
The usual treatments for toenail fungus include:
Topical Antifungal Medications
These are medications you apply directly to your toenails, with amorolfine and ciclopirox being common examples. The downside is that they often don’t work that well. In fact, research suggests that topical treatments cure the problem less than 10% of the time.
Oral Antifungal Medications
These are medications you take by mouth, such as fluconazole and itraconazole. They can be more effective, with improvement rates around 40% to 66%. However, they can come with side effects that you should discuss with your doctor.
Laser Therapy: A Modern Approach
Laser therapy is a newer option for treating toenail fungus.
How Laser Therapy Works
Laser therapy uses heat to kill the fungus and damage the surrounding tissue. Different types of lasers, like CO2 and YAG, are used with specific wavelengths.
How Well Does Laser Therapy Work?
Studies show varying results. One study showed a 61% cure rate after 16 weeks. Other research showed a 91% clinical improvement rate and a 30% cure rate after 180 days. Metrowest Podiatry Services claims an effectiveness rate of over 95%.
Benefits of Laser Therapy
Laser therapy means you might not need oral medications, surgery, or long-term topical treatments. Plus, it may work faster than topical treatments.
The Cost of Laser Toenail Fungus Treatment
Unfortunately, laser treatment for toenail fungus isn’t cheap. A single session can run anywhere from $100 to $400. For example, Metrowest Podiatry Services charges between $200 and $300 per session. And keep in mind, you’ll probably need multiple treatments to completely kick that fungus to the curb.
So, what determines the final price tag? Several things can affect the cost, including:
- How bad the infection is
- How many toes are affected
- The type of laser being used
- Where you live
If you’re worried about the expense, you can always use your Health Savings Account (HSA), Medical IRA, or Flexible Medical Spending Account (Medical FSA) to help cover the cost.
Will insurance pay for laser toenail fungus treatment?
If you’re struggling with toenail fungus, you’re probably eager to be rid of it. But you also want to be sure you can afford the treatment.
So, will your health insurance pay for laser toenail fungus treatment?
It’s tough to say. Here’s what you need to know.
General insurance coverage policies
Unfortunately, insurance companies often don’t pay for laser toenail fungus treatment. That’s because they may consider it a cosmetic procedure rather than a medical necessity.
Insurers may want proof that you’ve already tried other treatments that didn’t work.
That’s why it’s so important to contact your insurance company and ask about your plan. Here are some specific questions to ask:
- Is laser treatment for onychomycosis covered under my plan?
- What are the specific requirements for coverage?
- Are there any alternative treatments covered that I should try first?
Medicare coverage
Medicare Part B may cover medically necessary services, including doctor visits, diagnosis, and outpatient care. After you meet your Part B deductible, Original Medicare typically pays 80% of approved costs.
You may need Medicare Part D prescription drug coverage for oral antifungal medications.
Medicare may decide that laser treatment for toenail fungus is medically necessary if you have significant pain or trouble walking because of the condition.
Appealing a denial
If your insurance company denies coverage, you can file an appeal. To do so, gather documentation from your doctor explaining why the treatment is medically necessary. Then, follow the insurance company’s appeals process.
When to seek medical attention
If you notice changes to your nails, it’s important to get medical advice. Signs of a toenail fungus infection include:
- Discoloration
- Thickening
- Separation from the nail bed
You should also see a doctor if home remedies and over-the-counter treatments don’t work. People with diabetes or weakened immune systems should seek medical care right away. Untreated toenail fungus can get worse and lead to complications. In severe cases, amputation may even be necessary.
Frequently Asked Questions
Can you scrape out toenail fungus?
While you can sometimes remove some of the infected nail tissue by filing or trimming, or through debriding toenails, this is generally not an effective treatment for toenail fungus on its own. It might temporarily improve appearance, but the fungus will likely persist without proper treatment.
Does Mayo Clinic have laser treatment for toenail fungus?
Yes, Mayo Clinic and many other medical facilities offer laser treatment for toenail fungus. It’s always best to check directly with your local Mayo Clinic branch (or preferred medical center) for specific services and appointment availability.
Do at home lasers work for nail fungus?
The effectiveness of at-home laser devices for nail fungus is debated. While some products claim to improve nail appearance, scientific evidence supporting their efficacy is limited. Professional laser treatments are generally more powerful and likely to be effective.
How much does laser therapy for toenail fungus cost?
The cost of laser therapy for toenail fungus can vary significantly depending on the location, the number of treatments needed, and the provider. You can expect to pay anywhere from a few hundred to over a thousand dollars for a full course of treatment.
What is the best toenail fungus treatment consumer report?
Consumer Reports doesn’t specifically rate toenail fungus treatments. However, reputable sources like the American Academy of Dermatology and medical websites often provide information on the effectiveness of various treatments, including prescription medications, topical antifungals, and laser therapy. It’s best to consult with a podiatrist or dermatologist to determine the most appropriate treatment for your specific condition.
Final Thoughts
Laser treatment can be an effective way to get rid of toenail fungus, but many insurance plans don’t cover it.
If you think you have toenail fungus, talk to your doctor about the best way to treat it. They can help you decide whether laser treatment is a good option for you and help you explore all of your options.