Hi, Jeffery - and welcome.
Thanks for your generous words of appreciation for the ANA website and discussion forums.
I'm sorry you've been handed a diagnosis of an acoustic neuroma but you're in the very capable hands of Dr. Brackman and the HEI team. Considering your AN is tiny (4mm) I would suggest that you can observe it (via MRI scans) for possible growth for another six months to a year. Of course, irradiation is also an option but as you recognize, we don't presume to know what procedure is right for you. If observation indicates the tumor is growing, then you'll have to make a treatment decision. If surgery is your choice, Dr. Brackman's advice about the possibility of you losing your health insurance or HEI being out of your network is accurate (if a bit self-serving). However, I wouldn't hurry into such a serious surgery that could have a profound impact on your quality of life based only on financial issues and things that may never occur. However, these are difficult decisions that, in the final analysis, only you can make. You appear to be well-informed and quite rational and pragmatic so I'm confident you'll make sound choices. We'll be here to help, inform and support, as you need us.
Jim