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Thread: Questions about surgery

  1. #1
    Join Date
    Feb 2007
    Location
    The Woodlands, TX
    Posts
    142

    Questions about surgery

    I have some questions about surgery or planning for it, and I thought someone might be able to make suggestions or direct me to where I can find info. I know that I can ask my doctor these too, but March 1st and March 13th seem so very far away. Thanks in advance for any help.

    We have Aetna EPO. It's like an HMO. Does anyone know if this kind of surgery is covered by health insurance or HMOs? Would I need to contact Aetna for preauthorization of some sort? When is it best to contact the insurance company.

    Does the doctor arrange for the post-op rehabilitation fascility stay or is that something I need to worry about? Is it typical to be admitted the day before or the day of surgery? How long is the typical hospital stay? And rehab? When should I expect to be able to care for myself? how about my kids (15 months old)? How should I handle the 5 1/2 hour drive back to Houston? Should I by prone or reclined? Thanks everyone.

    Ann
    44 year old female
    Surgery on Nov. 1, 2010
    Dr. Darrell Hanson, Methodist Hospital
    Posterior Only, 9 hours
    Presurgical: T 61 Degrees, L 58 degrees, with 15 degrees of thoracolumbar rotation
    Postsurgical: T 26, L 25

  2. #2
    Join Date
    Jun 2005
    Location
    Maryland
    Posts
    408
    Call your insurance company and ask them. They are the best source of knowledge regarding what your plan does and does not cover. I can tell you that I have an HMO and my surgery, hospitalization,etc. was covered 100%.
    Brandi
    Congenital Scoliosis, 58* lumbar curve
    Combined Anterior/Posterior Spinal Fusion w/Laminectomy May 22, 2006
    L1-S1
    Dr. William Lauerman
    Georgetown University Hospital, Washington, DC
    Pedicle Subtraction Osteotomy @ L3, Posterior Spinal Fusion L2-L4, rod removal with re-instrumentation T10-S1 and Laminectomy February 5, 2009 to correct flatback
    http://brandi816.wordpress.com/

  3. #3
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,950
    Hi Ann...

    Every insurance plan is different, but I believe your doctor's office will need to get preauthorization. I don't recall anyone ever having their insurance company deny the authorization for standard scoliosis surgery. They may, however, deny elements of the surgery (anything that hasn't been proven to be effective).

    If your surgeon feels you'll need rehab, his office should arrange for it.

    It is not typical to be admitted the day before surgery. As to the average stay, it really depends on what you're having done. If you're having just one surgery, it's typically about a week's stay in the hospital and no rehab. By the time you're released, you should be able to get yourself in and out of bed, feed yourself, and walk at least as far as the washroom. You should be able to bathe and feed yourself, although you probably won't have the stamina to prepare even a simple meal for a few weeks.

    Your surgeon will probably tell you that you'll be restricted from lifting your baby for at least 6 months. At best, someone will be able to place him/her on your lap. You'll probably be told that you cannot lift or bend during the first 6 months. That means you're going to need to set things up properly in your home, or have someone who can help you.

    The drive home shouldn't be too difficult if you plan plenty of stops. For safety, you should travel sitting up, but you may need to lay down for 10-15 minutes during your frequest stops.

    These are all questions you should definitely bring up with your surgeon's office. Don't wait until the last minute, as you'll already be stressed enough without having to worry about insurance company approvals.

    I have a few pages on my website that you may find helpful:

    http://www.scoliosislinks.com/PreparingforSurgery.htm
    http://www.scoliosislinks.com/PostSurgActivities.htm

    Good luck.

    Regards,
    Linda

  4. #4
    Join Date
    Feb 2007
    Location
    The Woodlands, TX
    Posts
    142

    Thank you!

    Thank you Brandi and Linda! The info is very helpful. I wasn't sure if it was a good idea to contact the insurance company before even setting a date for surgery, but I'll do that. Thanks also for the llinks. They are wonderful.

    Ann
    44 year old female
    Surgery on Nov. 1, 2010
    Dr. Darrell Hanson, Methodist Hospital
    Posterior Only, 9 hours
    Presurgical: T 61 Degrees, L 58 degrees, with 15 degrees of thoracolumbar rotation
    Postsurgical: T 26, L 25

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