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  • It's the bill that hurts!

    Hiya, I'm new. Was researching how much surgery costs, and I found this forum. Apparently, surgery is anywhere from $60,000 to $200,000. I have insurance, but IF it pays anything, it's only 80%. So I'd need to pay about $25,000 to $75,000 or more, myself.

    I would love to get surgery within a year, but I certainly am not going to have that much money by then. And I just got all my credit cards paid off (which were used mostly for medical stuff), and I hate to go back into debt again.

    I keep looking for medical grants. Even if they're relatively small, it would still help, since Medicare/Medicaid won't accept me. But every time I do a search for medical grants, it's always for students in med-school! Does anybody know of a way to get one? Or any non-profit organization that might offer some finanical aid? Can't go to Shriner's, I'm too old
    I may be crazy, but it's kept me from goin' insane...

  • #2
    You should check your policy. Many policies have a cap on what the patient has to pay (something like 20% to a maximum of $5,000).

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

    Comment


    • #3
      costs

      Before a doctor will operate his office checks on the reimbursements a patient's insurance company will pay. This is done by submitting a surgical plan in advance.

      My doctor accepted what my plan paid(he's not in any plans)-which was considered out of network. I found working closely with the office staff up-front helped a lot and being honest about it. I actually found transportation and co-payments for the other doctors added up. I got money back on my income tax.

      Another alternative was NEVER use credit cards but work out a long term payment plan with tiny payments until you can work again.
      Some providers will write stuff off for hardship. One must swallow pride and talk about it in advance.

      I had a friend whose husband needed an angioplasty when he had no insurance($20,000)-then he left her -with the bills. She also had credit card balances. She wrote the hospital president after paying about half and he graciously forgave the rest.

      Karen
      Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
      Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

      Comment


      • #4
        Vivid-Dawn,
        When I had my scapular resection a few years ago, my doctor was "out-of-network". I paid the initial visit that went towards my deductible. After that was reached, I got 80% back that is "reasonable and customary". As far as the surgery, even though he was O-O-N, the hopsital apparently was "in-network" so I didn't pay anything for that. He also accepted what my insurance company gave him and didn't charge me anything. When I would go for my follow-up visits (after the three month-post visit limits were up), I paid for the visit and submitted it to my insurance company. When all was said and done, I think I paid out of pocket a total of perhaps $400? All tests (x-rays, cat-scans, etc.) were paid in full as they had them "pre-approved". It gets confusing at times with the in and out-of-network issues but with the "cap" (as Linda mentioned) and working with your doctor, it generally works out to your advantange. Good luck! Lynn
        1981 Surgery with Harrington Rod; fused from T2 to L3 - Dr.Keim (at 26 years old)
        2000 Partial Rod Removal
        2001 Right Scapular Resection
        12/07/2010 Surgical stabilization L3 through sacrum with revision harrington rod instrumentation, interbody fusion and pre-sacral fusion L5-S1 - Dr. Boachie (at 56 years old)
        06/11/14 - Posterior cervical fusion C3 - T3 (Mountaineer System) due to severely arthritic joints - Dr. Patrick O'Leary (at age 59)

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        • #5
          I had my operation fully funded by a government agency called Vocational Rehabilitation, but this is because I had to continually quit jobs because of my back. BUT!!!, I was moderately disfigured and I did suffer a lot of pain from my scoliosis, but not as much as I have since my surgery- a year ago. I would give anything to have my twisted painful back- back! It was nothing compared to having a fused spine with metal rods. Please be sure it is absolutely nescessary.

          Comment


          • #6
            Costs

            Hi,

            I only just registered and was asking questions about costs. I live in the UK and I get the operation free under the NHS. The only downside to this is that I have to wait b/w 6 and 18 months to see a specialist. This is really depressing as I am 27 years old and will very much like to get the operation over and done with and maybe start a family.

            US prices are sky high. Does anyone know anything about UK private prices? Also can anyone say anything about doing it in India? I hear they have great doctors out there.

            Comment


            • #7
              Hi Amaka...

              I was at a scoliosis conference for health professionals this summer, and a doctor from India presented quite a few papers. They're getting good results there. Unfortunately, they're using Harrington rods (which they can manufacture inexpensively), which can cause problems later on. India is probably a good option for those who can't get care elsewhere, but I'm not sure I'd sign up for it if I had other alternatives.

              Regards,
              Linda
              Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
              ---------------------------------------------------------------------------------------------------------------------------------------------------
              Surgery 2/10/93 A/P fusion T4-L3
              Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

              Comment


              • #8
                amaka

                i had private surgery in the UK this summer. i sent you a private message detailing more, i hope i can be of some help to you
                diagnosed aged 14 (2001)
                braced from july 2001 to february 2003 to hold curves
                fused T11-L3 on july 16th 2005 (aged 18)
                Discharged by surgeon july 11th 2007 (aged 20 and almost 2 years post-op)
                scoliosis support forum

                Comment


                • #9
                  having re-read your post amaka i have a couple of questions.

                  are you already seeing a consultant or are you on the waiting list for an initial consultation? if you've not had an appointment yet, booking the first one privately is a good way to jump the queue a bit
                  diagnosed aged 14 (2001)
                  braced from july 2001 to february 2003 to hold curves
                  fused T11-L3 on july 16th 2005 (aged 18)
                  Discharged by surgeon july 11th 2007 (aged 20 and almost 2 years post-op)
                  scoliosis support forum

                  Comment


                  • #10
                    Vivid-Dawn, I notice some people referring you to the UK. I now surgery is "free" there, but I assume they would do it for UK residents, only. Does anyone know about that? Kris

                    Comment


                    • #11
                      Hi there
                      Surgery is not precisely free in the UK: it is paid for out of the national insurance payment which all people earning more than a minimum amount pay (it's a percentage of earnings). It is 'free at point of use' however to all British residents - whether or not they are working and paying national insurance contributions. It would not be available to someone coming into the country purely to obtain medical treatment - you would have to emigrate here in order to become eligible.
                      Hope this helps to clarify how it works over here.
                      Lorrie

                      Comment


                      • #12
                        lorrie's right, however i know my surgeon has operated on people who have come from abroad, he mentioned a few years ago he'd had people come over from saudi arabia and then fly home two weeks later! (he only mentioned this because i was asking how soon i'd be able to fly again)

                        so to clarify - like lorrie said, you have to be a resident to get free healthcare (and even then the waiting lists are a bit notorious, as amaka pointed out) OR you can pay to have it done privately (i'm covered by health insurance until the end of march, and my bill was about £12,000 including a rod and 5 screws, 8 xrays, drugs, care, a week in hospital, anaesthetist and surgeon)

                        hope that's not confusing
                        diagnosed aged 14 (2001)
                        braced from july 2001 to february 2003 to hold curves
                        fused T11-L3 on july 16th 2005 (aged 18)
                        Discharged by surgeon july 11th 2007 (aged 20 and almost 2 years post-op)
                        scoliosis support forum

                        Comment


                        • #13
                          Lorrie, thanks for the info. I know people who come to the USA for a few years and kind of miss their own health system in Great Britain. Both systems have their pluses and all. Here, if you are indigent or at least have no property or anything that you would risk losing, you can get health care for free or at a sliding scale. In my case, my doctor said I would have to sell my cars, my house, clear out the bank account, etc., before the government would pay my emergency bills if my family had a sever situation (like spine surgery, over $100,000 without insurance or Shriners), so his advice prevented me from deciding to "just use the public health center" if my family ever had an emergency. I know people who have no insurance and depend on public health in the USA, but I am thankful I can afford the insurance and still have the comforts of house and home, etc. I wouldn't doubt that it would be a real struggle to get the government to approve of spine surgery as a procedure they would pay for in the case of uninsured adults here. Unfortunately, it may still be seen in the government as cosmetic only. I sure am glad I don't have to worry about it and got my daughter's surgery handled while she was a child and qualified for Shriners Childrens Hospital's free surgery for children. Thanks again for the interesting info! Kris

                          Comment


                          • #14
                            Re Cost

                            Thanks for all your replies.

                            I am currently awaiting consultation. Initially I met with a specialist doctor in Orsett Hospital and now I have been referred to see the consultant Mr Stuart Tucker.

                            Marmyte, please can you tell me how I can proceed with seeing a private consultant and then getting back on the NHS for the operation.

                            Thanks

                            A
                            Last edited by Amaka; 10-10-2005, 12:22 PM.

                            Comment


                            • #15
                              amaka that's my consultant hang on to him, he's BRILLIANT. you can see him privately, i'll catch you on msn or email about it
                              diagnosed aged 14 (2001)
                              braced from july 2001 to february 2003 to hold curves
                              fused T11-L3 on july 16th 2005 (aged 18)
                              Discharged by surgeon july 11th 2007 (aged 20 and almost 2 years post-op)
                              scoliosis support forum

                              Comment

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