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View Full Version : What does a big surgery like this cost?



babyboomer16
05-26-2010, 03:00 PM
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.

mbeckoff
05-26-2010, 03:22 PM
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

jrnyc
05-26-2010, 03:37 PM
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

Shari
05-26-2010, 10:38 PM
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.:eek:

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.:o

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.:eek:

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

Shari

jrnyc
05-26-2010, 10:48 PM
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 :rolleyes:

jess

naptown78
05-26-2010, 11:06 PM
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%.

jrnyc
05-27-2010, 07:16 AM
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! :rolleyes:

jess

mbeckoff
05-27-2010, 07:34 AM
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

LynetteG
05-27-2010, 07:56 AM
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 :)

mbeckoff
05-27-2010, 08:07 AM
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

Back-out
05-27-2010, 09:25 AM
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! :eek:)

Confusedmom
05-27-2010, 09:24 PM
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

jrnyc
05-27-2010, 09:52 PM
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 :rolleyes:...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

Shari
05-28-2010, 02:15 AM
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

jrnyc
05-28-2010, 05:24 AM
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

rich1752
05-28-2010, 03:49 PM
I am double covered with insurance. I have insurance and my wife does. They constantly fight each other on who is going to pay the bill. My bill so far is about 600K. I did stay at Cedar Sinai, which is an expensive hospital. My surgery took 12 hours and had both anterior and posterior. I stayed in hospital for a week. So far nothing out of pocket, but can't imagine not having insurance.

rich

loves to skate
05-28-2010, 09:33 PM
Hi Evelyn,
I had a Medicare Advantage PPO Plan and I went out of network. I paid $750.00 for the hospital bill, nothing for the rehab hospital and about $1,500.00 for the Dr. bill. Being on Medicare, you should only have to pay 10 or 20% of the Medicare allowable amount which is way lower than the actual bill. My insurance paid my Doctor about $14,000.00 of his bill for $55,000.00. He didn't have a contract with my insurance company at the time. I have no clue how much the hospital bill was. Every insurance policy is different, so you really need to check with your insurance company what your share will be.
Sally

jrnyc
05-29-2010, 01:42 AM
if i do this, i will want to know which doctors will be in that OR besides my surgeon..who will be assisting, who will be "monitoring" my spinal cord, etc..because those are the "surprise" bills afterwards!

jess

Vali
05-29-2010, 09:27 AM
My surgery here 'downunder' cost almost $70,000. Medicare and my private health took care of everything. My out of pockets amounted to about $450.00.

Shari
06-03-2010, 09:50 PM
Back out, Thank you for the belly laugh from your comment about the organ holder. It's so weird how there are certain things that crack me up when I look back on them:). I have quite a few!!!

Thanks,
Shari

Back-out
06-04-2010, 12:18 AM
I have been thinking a lot about this organ holder business, actually, It holds a morbid fascination for me as a perfect example of the imponderables of life and this experience.

I'm asking myself, "how does one train to be an 'organ holder' and just what is his job title? It can't help sounding either a little risque or musical.

(Cocktail party scene, Suave, laid back gent holding his martini across his manly chest being asked, "and what do YOU do, for a living?"

"Heh, I'm an ORGAN HOLDER!" :cool: Jaws drop, but admiration reigns, After all to anyone who knows, this is a dude who rakes in [$44,000 "/. 10 = 4,400/HR!! ) Good God, he might as well be on wall street! That's tidy sum.

Does one ever wonder if it was an organized scam of some kind? Especially his billing you right away in Collection after one year, with no prior billing. Come-ON! That's a racket...

(Did he do anything with them while he was holding them? Was he just holding them to the right or left as needed? Sheesh! :rolleyes:)

leahdragonfly
06-04-2010, 08:01 AM
The "organ-holders' you mention are either general surgeons or vascular surgeons. Do not begrudge them, they are there to save you from bleeding to death if your surgeon accidentally injures a major blood vessel. They are also there to make sure your internal organs don't get injured. So although you have imagined a ridiculous name for them, they are actually quite important!

Back-out
06-04-2010, 11:16 AM
I never thought they weren't necessary. I only begrudge the ones who accept a job (maybe it's the hospital's fault), for an unconscious patient whose insurance they don't accept. That's a huge bill to come at a patient - and a full year after the surgery too, with apparently no prior billing!

Shari's story has scared a number of us - and rightly so. I am thinking of working with a paid patient advocate to get something signed by the facility so there's no chance of a physician being called in who's not a preferred provider for my insurance! Most of all when I'm deep under and in no position to object. :eek: The humor was a way of dealing with the anxiety.

I also think patients need protection against this practice whatever the specialty. The hospital and primary surgeon are certainly sure to get guarantor signatures from the patient in advance, and the patient can afford such an unexpected loss far less than either one!

Shari
06-04-2010, 11:24 PM
Amanda, You are too funny!!! I just hope while he was handling my organs, he used both hands, and a mask. He never intended to scare anyone. If you have the anterior part of the surgery, they have to be moved off too the side somewhere. However, I still wonder if he put everything back in the same place:eek::D.

Shari

mbeckoff
06-18-2010, 11:57 PM
I received the bill for the operation from the hospital and the 7 nights that I was in the medical center part of the facility. I have not received the bill for the rehab as of yet. The bill was $289,806.77. BCBS has picked up all of it except for $480.93. I was in Intensive Care 2 nights, a step down room 2 nights and then a private room 3 nights before moving over to the rehab.

I still have not received my surgeon's bill nor the kidney specialist that they had to call in for me.


For once, BCBS actually is paying something.Usually our policy does not pay for much of anything


Melissa

jrnyc
06-19-2010, 05:08 AM
i am surprised at that comment about BCBS...Dr Anand in CA took BCBS and didnt take my Aetna HMO...maybe you have a BCBS tht is like an HMO...? i know some doctors wont take an HMO type policy, when they will take the same company with a PPO policy...pays much more....and also costs patient much more!
hope you are feeling better every day, Melissa..

jess

mbeckoff
06-19-2010, 10:08 AM
no this is a PPO but my husbands company is very cheap. That is why I was very pleasantly surprised.

I had been feeling better until Thursday when it all went downhill and I am in terrible pain and cannot get any relief

Melissa

ShariMSU
06-19-2010, 01:28 PM
My surgeons office and the hospital worked as a team and gained all prior approvals that would be needed for every step of the procedure and stay.
This was such a nice thing so that I did not have to worry and they took responsibility for it. I called to see if i should do anything and they said we have taken care of all approvals. My guess was it was more for their benefit, this way they did not do surgery or have hospital stay that they wouldn't get paid for. But of course it was explained as a service to me. Ok with me. Everything was covered 100%. I did have a $79.00 bill to hospital as we requested a single room and that was my portion even though room was $200 a night. Having great insurance was one reason I opted now for surgery, along with all the medical reasons.

jrnyc
06-19-2010, 06:06 PM
hey melissa
i am so sorry to hear that you are in such pain...have you spoken to your surgeon? weekends are always bad in terms of reaching any doctor! i hope you at least get to talk to his office...and to him directly by Monday...maybe they can change the pain meds or something...? it does seem that most on forum write about recovery being alot of ups and downs, especially in the beginning......but i think you should talk to them about this...

hope you get some relief!

jess

mbeckoff
06-19-2010, 09:36 PM
I called on Thursday and his nurse said that she would talk to him Friday because he was in surgery all day Thursday . Friday I spent most of the day sleeping. They did not call yesterday which is very surprising as they always call back. I will call on Monday

It is definitely up and down recovery

Melissa

jrnyc
06-19-2010, 11:53 PM
hope you hit the next "up" part really soon! and maybe call again on Monday..

jess

mbeckoff
06-20-2010, 08:43 AM
Thanks Jess

I hope so as well

JenniferG
06-20-2010, 04:14 PM
Hope you are feeling much better today Melissa.

coscottsx61
06-20-2010, 04:49 PM
I just finished reading your entire question and answers. I am having 2 surgeries = 1st from the front for the base of the spine with 3 surgeons and the 2nd from the bask to correct the rest of the spine and maybe remove my existing rod from 1976.

I guess I am too blonde right now. I thought maybe $100,000 for all. I am more worried with getting prepared mentally and with my 3 boys at home and never gave the cost a second thought.

Our insurance only pays 80% and we are stuck with the rest of the bill. HOLY CRAP!!! That will be a big bill.

We are a single income family. We'll have to wait and see what this will look like but thanks for the question and all the answers.

LindaRacine
06-20-2010, 05:15 PM
I just finished reading your entire question and answers. I am having 2 surgeries = 1st from the front for the base of the spine with 3 surgeons and the 2nd from the bask to correct the rest of the spine and maybe remove my existing rod from 1976.

I guess I am too blonde right now. I thought maybe $100,000 for all. I am more worried with getting prepared mentally and with my 3 boys at home and never gave the cost a second thought.

Our insurance only pays 80% and we are stuck with the rest of the bill. HOLY CRAP!!! That will be a big bill.

We are a single income family. We'll have to wait and see what this will look like but thanks for the question and all the answers.
Hi Jill...

You might want to check your insurance plan. I think that there is often an annual cap on the 20%.

--Linda

mbeckoff
06-20-2010, 06:07 PM
I just finished reading your entire question and answers. I am having 2 surgeries = 1st from the front for the base of the spine with 3 surgeons and the 2nd from the bask to correct the rest of the spine and maybe remove my existing rod from 1976.

I guess I am too blonde right now. I thought maybe $100,000 for all. I am more worried with getting prepared mentally and with my 3 boys at home and never gave the cost a second thought.

Our insurance only pays 80% and we are stuck with the rest of the bill. HOLY CRAP!!! That will be a big bill.

We are a single income family. We'll have to wait and see what this will look like but thanks for the question and all the answers.


What ever the balance is you can work it out . We have most likely $50,000 worth of other medical bills and as long as we send them a small amount monthly they are OK with it

Melissa

mbeckoff
06-20-2010, 06:07 PM
Thanks everyone for the good wishes

I am going to call my surgeon tomorrow as the pain is still there

Melissa