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  • What does a big surgery like this cost?

    I was just wondering what this kind of surgery is going to cost. I will be fused (as far as I know) from my pelvis to the middle of my shoulders. T7 I think. I have another appt. before the surgery(July 1st is surgery) and will find out more then. I am on disability. And so I have a medicare ins.(Secure Horizen) without coinsurance. Secure Horizen has a contract with Medicare, It carries my drugs too. I pay out of pocket expences that they don't pay. So I am expecting this to cost a lot. Any idea guys ? Sure appreciate any response. Thanks in advance.
    Linda Brozik~~60 yrs. old at time of Lenke's first surgery. 62 now!
    Surgery 2006 L3/4 L4/5 double fusion/ instumentation/ With 2 cages
    This started adult onset scoliosis
    July 1st, 2010/ surgery ~~fused T10 to pelvis (long rods/ screws)
    Oct.20th 2010, extended rods to T4 / did osteotomy at L3
    Oct. 29th 2012 Dr. Lenke St. Louis Mo. T4 to sacrum osteotomy anterior cage L3/4 titanium rods
    May 30th 2013 revision
    May 8th cervicle surgery 2016
    May 31st Dr. Gupta revision 2017

  • #2
    I just had my surgery on May 4th.I have received one bill for the first part of the hospital stay from May 4th until May 11.On May 11,I was moved to the rehab part of the hospital. The bill I received was just for the hospital stay,no doctors, no OR. The bill was $289.000. Now that got sent to BCBS and I will see what they will pay. I will be getting many more bills .

    I was fused from T2 to sacrum

    Melissa
    Last edited by mbeckoff; 05-26-2010, 03:22 PM. Reason: more information

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    • #3
      OK...i dont understand this...insurance companies, if accepted by the surgeon, cover most of the bill...as a matter of fact, when i flew out to see Dr Anand at Cedars Sinai Hosp, the nurse said he would take Medicare for hospital part but BCBS for his fee...i dont have that insurance, so i couldnt use him...
      however, the NYC surgeons who take my insurance, plus Medicare, i expect would cover most of the bill..i wouldnt mind getting some minor bills, but i wouldnt want to get the ones that are thousands of dollars each!! and i do believe that this surgery costs hundreds of thousands if not insurance paid! at least, that is what i heard from a certain world renowned surgeon in NYC when i paid him a one time fee in cash for a consult....

      jess

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      • #4
        This is one of those subjects that chaps my cheeks!!! Preparing for this surgery is already mentally exhausting. Then what they don't tell you is, that you have to look in every nook and cranny so you don't get "screwed" anywhere besides your spine.

        I thought I had it all covered, right Dr. for the insurance company and so on.
        The first bill from the hospital arrived at home before I did??? Every one I got had a different amount??? I was told to wait it out and see what would get paid, and also there would be no more than $1500 out of pocket. Silly me.

        Just about a year post-opp, I got a phone call from the Collector of unpaid bills.
        He asked me if I could make a $1500 per month for a unpaid bill of $42,000. I kind of snickered from shock and pissed the guy off.

        Things got strange for awhile. Then I finally found out that this bill was from the Dr. that moved my organs in the anterior part of my surgery, which I had no choice in that matter. Called the insur. co., only to find out that they had offered him $25,000 and he refused it. Well by this time my ex-husband local had changed insur. co.

        Eventually I applied for the charity that every hospital has. Total bill--$350,000. Yee haw

        Shari

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        • #5
          wow...be enuf for me to skip the whole thing, pain and all...to have a debt like that hanging over my head...dont need it!
          if i go thru with it, i'll probably ask my surgeon for a guarantee about the bill in writing..he did mention there'd be someone there monitoring the spinal cord, etc, ...dont know about insurance, but id think it would kinda be required! minimally invasive approach i dont think requires moving organs around, least i dont think so

          jess

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          • #6
            $$$$$$$$$$$$$

            My first surgery cost in the neighborhood of $300,000, and my ins company paid their discounted rate which ended up being $189.000. My deductable was $500. I had GREAT insurance then which covered 100% of everything. My only cost was that $500.
            My 2nd surgery, I am still getting billed for. My insurance is different now. My deductable is $1000 with total out of pocket $1500. So far my bills have exceeded $250,000 which my insurance will discount. So my total expenditure should be $2500. Still alot of money, but what would I do w/o insurance? I am not sure what Medicare covers, but isn't it 80% with a 20% copay? If this is the case, be sure to get a supplement plan to cover the 20%.
            May 2008 Fusion T4 - S1, Pre-op Curves T45, L70 (age 48). Unsuccessful surgery.

            March 18, 2010 (age 50). Revision with L3 Osteotomy, Replacement of hardware T11 - S1 , addition of bilateral pelvic fixation. Correction of sagittal imbalance and kyphosis.

            January 24, 2012 (age 52) Revision to repair pseudoarthrosis and 2 broken rods at L3/L4.

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            • #7
              hmmmm...i have medicare part A and B, plus a regular (not supplement) private HMO insurance that i pay every month for...
              wonder if that would cover it...

              nothing like worrying about bills on top of being wracked with recovery pain!

              jess

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              • #8
                I have many other medical bills that I am unable to pay in full every month. Most likely to the tune of over $50,000 for our family of four . We just send $10 a month for each bill and that is that . As long as you are making an effort to pay the bill, they cannot come after you

                Melissa

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                • #9
                  Wow Melissa, I thought I had a lot to pay out right now. I have approx. $20,000 of bills to pay off since surgery and my litigation bills with my ex. Still we're fighters - right Melissa? We'll get through this and come out stronger in the end
                  Lynette - 44 years old.

                  Pre-surgery thoracic 55 degrees
                  Pre-surgery lumbar 85 degrees

                  Post-surgery thoracic 19 degrees
                  Post-surgery lumbar 27 degrees

                  Surgery April 1st 2010.

                  Posterior spinal fusion from T9 to sacrum.
                  Dr. Cronen at University Community Hospital - Tampa, FL.

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                  • #10
                    Originally posted by LynetteG View Post
                    Wow Melissa, I thought I had a lot to pay out right now. I have approx. $20,000 of bills to pay off since surgery and my litigation bills with my ex. Still we're fighters - right Melissa? We'll get through this and come out stronger in the end

                    i feel stronger in many senses of the word since I have had the surgery and hope to continue going forward

                    Melissa

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                    • #11
                      Thank you! This is a life-saving thread. I thought if the hospital, anesthesiologist, rehab and doc accept my insurance, I was all set. Even ahead of the game, since I've hit-stop loss which should pick up co-pays.

                      I guess the big thing is to make sure you don't have anyone working on you who is NOT on your insurance plan. Somehow to set this in stone BEFORE you go under (picturing some "organ holder" - ? - waking me up mid-surgery to sign a consent form! )
                      Not all diagnosed (still having tests and consults) but so far:
                      Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
                      main curve L Cobb 60, compensating T curve ~ 30
                      Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

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                      • #12
                        I thought that if you used an "in-network" surgeon and hospital, then the insurance had to cover the rest as "in-network." So, for example, if the anesthesiologist wasn't technically "in-network," they would have to pay the bill anyway because you didn't have any choice in the matter. Is that wrong?

                        Shari--that stuff about the guy who moved your organs sounds horrendous. Did you have to end up paying that?

                        Evelyn
                        age 48
                        80* thoracolumbar; 40* thoracic
                        Reduced to ~16* thoracolumbar; ~0* thoracic
                        Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
                        Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
                        Not "confused" anymore, but don't know how to change my username.

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                        • #13
                          hi Evelyn
                          i've had it happen to me once when i was in as an emergency with septesemia (splg?), otherwise known as blood poisoning! very deadly! had emergency care from a doctor other than my own insurance doc...in the ICU!! got bill later, and I alone was responsible for it! no one cares if you were half unconscious and in no shape to argue it ...only the patient must pay...hasnt changed over the years, either!
                          i think we sign a general agreement to pay, even though i went in thru emergency...you know, the thing that says i'll pay what my insurance wont pay..it's standard at every single hospital in country!

                          jess

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                          • #14
                            Evelyn,
                            No, I was accepted for the charity program. Every other offer my insur. co. gave was accepted. And it was not my fault that the hospital gave me a organ mover w/o checking w/ my insur. co. I was more of a pleaser than a fighter, but when you rearrange my body, and I became so confident, if I survived the surgery, then I could handle anything.

                            So I refused to give up when I truly believed I was in the right.

                            Having successfully going through w/ this surgery gave me the strenght to fight for my rights.

                            Shari

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                            • #15
                              well, i didnt apply for a charity program..was told it was rare...that i worked and would never be approved for such a program...i just paid off the doctor's bill piece by piece..he was a kind surgeon (put in an IV line at my bedside as emergency!)...and cancelled my last 2 payments when he noticed it was hard for me to pay it off in full all at once! nice guy!

                              jess

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