Surgery cost!

[MichaelK]

Are these costs normal?

My 17-year-old son had spinal fusion in March of this year and is doing quite well. His 58 degree curve was reduced to about 26 degrees and he's been back in school for a couple of weeks now. During the surgery the team implanted two titanium roda (with screws) and fused seven vertebra. Before the operation my son's orthopedic surgeon assured us that our insurance should cover all the costs. Our Blue Cross/Blue Shield policy has been excellent and quite comprehensive in the past and paid everything for the medical personnel involved. I was shocked, therefore, to receive a bill from the hospital for almost $26,000. It seems our insurance covered everything except the appliances (I assume the rods and anchoring devices). The charge for the titanium components was more than $25,000 and the insurance only paid $600. We sure wern't expecting this and didn't make any provision for that kind of cost, especially with my son starting college in the fall. Is this normal? Do the titanium components REALLY cost that much? If so, WHY? Thanks for any help you can provide.

[Carmell]

My son (age 9) has two adjustable titanium rods in his back/chest. The actual cost to the hospital from the manufacturer was $25,000 for both (one was $17,000 and the other was $8,000). The insurance company paid a big percentage of the total hospital bill, including the cost of the hardware (they paid $65,000 of the $75,000 billed - a rarity these days). Every 6 months, he has surgery to lengthen the rods. Each of the locking devices (small pieces) cost $900. My insurance (so far) has been paying the cost for the pieces as well.

If I were in your shoes, I'd be calling the insurance company to find out why they only paid $600 of the $25,000 cost. What is their reasoning? Find out what your out-of-pocket costs should be (i.e., deductable, co-insurance costs, etc.) and find out if the hospital is a provider of BC/BS. If they ARE a provider of BC/BS, they should accept what BC/BS pays as payment in full. They shouldn't bill you for the balance. The hospital would bill you for the balance if they are not a BC/BS provider.

Good luck!

[lrmb]

Hi, sorry to hear about that bill, it's everyone's worst nightmare. It made me remember I had read someplace about different coverages for different materials - maybe they didn't want to cover the titanium and that's why this bill was different. If your surgeon wanted to use specifically titanium rods then surely there would be a way of working this out... You might ask if this was the reason you got billed so much. Let us know what happens. Laura

[nikyergen]

We have Blue Cross/Blue Shield for insurance also. The reason we chose Shriners Hospital was because we were extremely worried that there would be an incidental that our insurance wouldn't cover. We didn't want any unexpected financial surprises. I am so sorry to hear your misfortune. But, I agree with Carmell. I'd be on the phone to the insurance company and finding out what was going on. I'd probably be raising the roof. Because I am sure that you had to have a pre-approval for this surgery and they should of stated then that they wouldn't cover that expense. $29,000 is a lot to have to pay, especially with college expenses coming in the fall.

I will praying for some answers for you. Hopefully, it was an error on the insurance company's part. Let us know what you found out.

'til later,
Nikki

[susannajon]

Hi MichaelK,

I really hate insurance companies sometimes! Thank goodness they're there to cover costs, but it's always a battle. I swear they try to deny the claim with the hope you'll just accept it and pay the bill. I suggest you dispute that charge with your insurance company all the way to the top. Don't throw in the towell. It has been my experience that if you fuss you can get it paid.

[Sheena]

its such an expensive surgery, mine was just over £20grand!!!
if i had stayed on NHS i would have had to have waited for a long period of time (they wouldnt tel us how long though)so we went private. thank god we did though because it was done quickly.
im glad my mums company paid for most of it, we had to pay a bit towards it, but it wasnt enough to put us out of pocket!
my dad jokes with me when i tell him my christmas list and he tells me my op was my present!!!
speak soon
sheena xxxx

[violinprincess3]

compared to my bill, yours is cheap. my titanium rod+screws cost $80,000 alone, and with everything else except the actual surgeon's bill, it totaled over $120,000. all i can say is thank god for life insurance.

[lancerlabrador]

Costs of Surgery

My Son just had scoliosis corrective surgery last week . The Surgery was very successful and the care he recieved at the Hospital for Sick Children in Toronto, Canada was phenomenal . The Cost to us other than daily parking was absolutely zero - thanks to our medicare system .

The fact that other Parents go through the same anxiety ,stress and apprehension that we experienced have to additionally worry about financial costs is very troubling to me . These are children , why should any manner of treatment be based on financial ability to pay. Nothing brought home the point more than reading the comments contained in this " thread" .

I have often heard our system discussed in your polarized media . What does a fifteen year old in pain know or care about " socialized medicine " . Personally I think that it is shameful. It is about time that your leaders in the States realize this moral committment and cease using proper medical care as a political football

[lindabar]

seen both sides

I'm an American with permanent residence in Australia and I can tell you each health system has its pros and cons. Your son's surgery may have been free but adults in Canada have been refused surgery-check out some posts at this site. My surgeon in Australia charges double what the government pays. He may waive his fees for children, but most of us have to pay him and the anesthetist. In Australia, one can opt for expensive private insurance (employers don't kick in anything). Ours only covers hospitalization. My bill for A/P is about 11KAU for anesthetist and surgeon, everything else was covered. I would not have had the operation here if I had to go the public hospital route. Those without insurance probably do better if in a national healthcare country. I think it's about the same for those people with decent health insurance in the US. I'm under the impression that in Canada the only option is the national health, there are no private hospitals or insurance? I don't know if that's true or not.