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Thread: Surgery costs

  1. #1
    Join Date
    May 2007
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    40

    Surgery costs

    Just curious about what, if anything, the surgeries are costing people these days. Does your insurance cover it all or are you out of pocket?

    We didn't have to pay a penny for my daughter's surgery - our only cost was the travel to the city and accomodations while there. Thanks to the Canadian health care system so far - although we did pay for this somehow indirectly through our health care premiums and taxes...
    ******************

  2. #2
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    Mine was roughly $260,000 before it was discounted (by about a third) via contractual insurance agreements.

    When I decided to have surgery in late 2007, I switched to a high deductible plan (HDMP) with a Health Savings Account (HSA) for 2008 from my employer's PPO.

    Although the same doctors are "in-network" on both, the HDMP dropped my deductible (and out of pocket) to $2500, and that could be paid out of my HSA (Health Savings Account, funded with pre-tax dollars - half of which my employer kicked in ... so my real OOP was $1250).

    Of course there are always costs that insurance consider "beyond reasonable and customary" (anesthesiology is consistently in this group) - and they will only cover a certain portion. I also had to argue with them about paying a seriously reduced rate for Hanson's PA ... as IF one set of hands could do this surgery!

    Anyone who's seen my surgery photos knows there are a LOT of people involved ;-).

    Karen, out of curiousity, how long does it take to schedule surgery in Canada?

    Unless someone is under 19 (and can have the surgery for free at Shriners), I don't imagine many adults in the States could afford it without insurance. Unfortunately, our system is rather broken ... and there are too many people who aren't insured .

    Regards, (and Happy Thanksgiving to all in the U.S.!)
    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  3. #3
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,901
    The costs for my daughter's surgery (T4-L1, Wed - Mon stay) at UNC-Chapel Hill Hospital were as follows:

    Surgery - $77,425.08 (8 cents ). Co-pay was $736.46.
    Surgeon - $11,543. Co-pay was $833.53
    Anesthesia - $2,451. Co-pay $55.87
    Other things (radiology, etc.) - a few thousand as far as I can tell with proportional co-pay.

    We lived in Calgary Alberta of 2003 to 2006 as US ex-pats. We had US-based health insurance. I never knew if this was good or bad w.r.t. being a Canadian citizen and having the provincial/national insurance. We had no major medical expenses during that time abroad. I suspect if we did, we would have returned to the states for that.

    I was told by a physician friend that the way Canada keeps medical expenses down is to ration the number of doctors, surgeons, etc. Hence the long waits for certain procedures.
    Last edited by Pooka1; 11-27-2008 at 05:59 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  4. #4
    Join Date
    Oct 2008
    Location
    Sunshine Coast, Queensland, Australia
    Posts
    3,261
    We live in a complicated world don't we?

    In Australia, we don't generally have employer funded health insurance, though it can be part of a salary package. I pay into a private health fund that so far, I have not made any claims on. It is not top of the line, just basic ($75 per month) and only covers hospital, not "medcial".

    In other words, I will be up for a small co-payment for the room and the theatre, the surgeon will cost me just under $5,000, out of pocket, then there will be the anaesthetist, physiotherapist, pharmacy, x-rays etc. Some of these will be employed by the hospital in which case, there will be a co-payment, but if not, I will pay the full cost.

    At this stage, I can only guess what it will end up costing but we're expecting in the region of $7,500 o.o.p. from the first visit and x-rays to the final post-surgery visit. Some of that we may get back through the nationally funded Medicare scheme. But being a newby at this, I'm not sure exactly how much.

    I'm hoping I will eventually consider it money well spent.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  5. #5
    Join Date
    Nov 2007
    Location
    Houston, TX
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    I suppose locale CAN have an effect on cost, and also whether the surgeon is SRS.

    (Not dogging Campion, Sharon, just noting that the SRS fellowship IS an extra expense to the consumer ...)

    Mine was performed by an SRS surgeon with Baylor Orthopedics (in the Texas Medical Center, Houston) at Methodist Hospital. My hardware is also Vitallium.

    Ain't nuttin' cheap about any of those factors.

    BTW, I was also fused T4-L1, and left on the morning of Day 6 (Tuesday to Monday stay).

    And, Sharon, I also laugh at $.08 on bills. We can round our Federal Income Tax, but they can't miss out on 8 cents?! After they discount for contractual obligations with insurance companies??? C'mon.

    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  6. #6
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,901
    Pam, I think those are the discounted, negotiated amounts because I got them off the insurance website. But I don't know that. It's what the insurance paid out so I think it is very likely the discounted, not original, amount.

    In re SRS affiliation, I've noted before that we were handed off to Campion by an SRS surgeon who sends his own daughter to Campion rather than an SRS surgeon for some reason. I think I know the reason.

    Also as I mentioned, Campion showed up on a recent list of doctors that other doctors go to for themselves and their family. Again, I can easily guess the reason for Campion being on this list.

    AFAICT, Campion does as many of these surgeries as some SRS surgeons per the nurses at the hospital. He simply doesn't consider it a specialty so he doesn't join SRS.

    So I agree if someone was starting from scratch, they should stick with the SRS list. But that doesn't mean a non-SRS guy can't do a top-shelf job and in fact cure your kid as happened in my case.

    Anyway, isn't the cost of being a member of SRS similar to being a member of any scientific organization? Mine ran between about $60 and $100 bucks a year. How much do you think SRS surgeons add to their bill to cover SRS membership?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  7. #7
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
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    Sharon, I qualified my SRS statement. SRS docs can specialize in several different areas of scoliosis or degenerative/aging spine. The SRS designation means they do a special fellowship - and devote at least 20% (most devote 100%) to the specialties. A year's fellowship isn't equivalent to $60-$100, either.

    Again ... no disrespect, but my surgeon would never do a rotator cuff or ACL repair. Campion is a Sports Ortho. That doesn't mean he didn't do a great job on Savannah's back: It only means he's "spread out".

    No doubt about it, I wanted specialization. I have more than a FEW Sports Ortho's for those other issues when I tear stuff up on the ballfield. Campion may do as many scoli surgeries as some SRS surgeons in NC, but I hardly believe he does as many scoli surgeries as Hanson. Aside from private practice, Hanson and Rex Marco are the primary surgeons at Shriners Houston.

    I'm in no mood to debate "your surgeon vs. my surgeon". I was simply trying to state why the costs vary, and UNC-Chapel Hill compared to Houston is a LARGE factor - as are credentials.

    Quite frankly, I qualified everything I said in my first post (that I was NOT attacking your surgeon).

    Take it for what it's worth.


    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  8. #8
    Join Date
    May 2007
    Posts
    40
    [QUOTE=txmarinemom;67926]
    "Karen, out of curiousity, how long does it take to schedule surgery in Canada? "


    I don't really know what the average adult wait time for surgery would be. I know for MRI's many adult people have to wait for up to a year. In my daughter's case, she didn't have to wait long for an MRI at all - 6 weeks I think. Once the decision to have surgery was made in June, the earliest surgery date we could get was in November - so I guess it was 5 months - which in our case was good because we needed that time to mentally prepare.

    However, on the day of her schedule surgery (Nov 20), (after we were already admitted) they cancelled it on us due to there not being any room in ICU for her after. Since her surgery is considered elective, we got bumped to a date 10 days later. Unfortunately, this had the domino effect of bumping everyone else but we were given priority because of the unexpected cancellation. This was at Alberta Children's Hospital in Calgary.

    Karen
    ******************

  9. #9
    Join Date
    Jul 2008
    Location
    Perth, Western Australia
    Posts
    108
    We have been very fortunate. I chose not to have private health insurance, although i seriously considered it at various times in the past. Consequently, we went public and naturally,it was all free. I honestly don't believe it has been for the worse as Tahlia has had the BEST treatment and care imaginable. She is in a single room of her own as well as in ICU, she also had her own room (I believe because she is a child in an adult hospital) and the only difference i could possibly ascertain re private vs public, is that her surgeon would have followed up with her more often. By that I mean, when the ortho team came to follow up with her, it was her surgeon's resident and registrars, the junior doctors, who i was most happy with and had complete confidene in anyway. We have had a stream of different doctors and staff anyways, depending on where she was (ICU docs, HDA docs, ward duty docs, etc, etc.,) but knew that her surgeon was reviewing her in consultation with others constantly, whether he saw her or not.

    I have often wondered about the private vs public issue and think that if my daughter had to go through this again (heaven forbid!!) I would not hesitate to go public again. I just wouldn't be able to justify paying a hefty 5 or 6K for an additional visit or two from her surgeon.

    However, I have read this thread with interest as I have wanted to know precisely how much it all did cost but guess I'll never really know. By the way, I know a lot of people have pre and post-op x-rays. Did these come at a cost? Were they emailed or put on disk for you? I did ask the HDA doc for her to email them, but she said i had to request that of my surgeon. I am now wondering if they may charge me for this?

    Anyone know?

    Cheers,
    Lisa

  10. #10
    Join Date
    Mar 2007
    Posts
    213
    Hi Lisa,

    You should not have to pick up the whole tab on the x-rays et al.. *IF* anything, you might be billed for a small gap between what the public system will pay for & what it costs - but that's only about $10-$20 for a set of x-rays

    I'm going "private in a public hospital". I don't understand the whole thing too well either, but I think there are 2 major differences with public vs. private in Aus.. 1) If you have higher-end private cover, you can be operated on in a private hospital, many of which are touted as more "plush" or better equipped, or what have you; & 2) If/when the public system is clogged up & all its public hospital surgeons are booked out years in advance (believe me, this happens!), going private will often get you in much, much quicker. Of course, there's the added bonus for the govt. that they don't have to foot the bills

    Re. costing, I will have to cover a few gaps between what my cover (which is pretty low level) pays and the official charge. All up, at the low end of a few of hundred dollars. Thankfully, whether a person goes public or private, the instrumentation is covered! I breathed a huge sigh of relief when that one was confirmed - my new metalwork will be worth about $30,000 just for the lumbar/pelvic rods!! Back when I had the previous two, I remember each set was worth around $20,000. Phew!

    At least here in QLD, there's been a lot of ongoing media coverage of some terrible hospital staff shortages, negligent doctors, etc.. So much so, that when the topic comes up, I'm almost compulsive about telling people that the public system is waaaaay strained, yes - but the people are GREAT. The vast majority of doctors, nurses, & other workers that help the hospitals tick are Magnificent, Professional, and Caring. I'm so glad to hear that Tahlia has had the same positive experience

    Cheers.

  11. #11
    Join Date
    Nov 2008
    Location
    Greenfield, WI
    Posts
    414
    That was a question I also had...in regards to the cost. I have a decent ins coverage from my employer & when I called to ask questions, I was advised that all I will be paying is the 250.00 admit. co-pay for the hospital stay, after that everything is 100% covered...no yearly max. After reading all of your replies...Im doubting this is for real? I kinda thought 250.00 for this complex surgery was too good to be true?! Thoughts? Oh, and Happy Belated Turkey Day to those who celebrated! I ate way too much!
    Lynn -30.... something
    DxD @ 8 yrs old: 10* curve-no brace-no nothin'!
    At age 26: Thorasic 48*/Lumbar 50*
    At age 34: Thorasic 58*/Lumbar 60*
    Posterior T5-L4 Fusion Jan 14th, 2009 w/Dr Tribus
    UW Madison, WI Hospital
    **AFTER: less than 10* Thorasic/15* Lumbar**

  12. #12
    Join Date
    Jan 2007
    Location
    Ontario, Canada
    Posts
    140

    scheduling time for surgery in Canada

    Despite the talk of very long wait times in Canada for medical procedures our experience with our son has been relatively good. He needed an mri and as long as we were willing to travel anywhere within Ontario we got an appointment within 4 days. Bonus, it just happened to be fairly close to home. It took 3 months to be first seen by his surgeon. From the time surgery was decided it took 2 months to have the surgery. Don't know if we just lucked out, whether it was Patrick's continued rapid increase in his curve (it was past 80 degrees at time of surgery) or having a very outspoken doctor influenced what I consider very short wait times for Canada.
    However I believe this is not the norm in Canada.
    Ramona
    mom of Patrick, age 15 at time of surgery
    diagnosed July 2006 curves T58 L 38

    Nov. 2006 curves T72 L38
    also lordoscoliosis

    feb.2007 curves T79 L43

    Surgery May 16 2007
    fused T4 to L1

  13. #13
    Join Date
    Feb 2007
    Posts
    254
    I paid $250.00 for my hospital stay and surgery.
    Patty 51 years old
    Surgery May 23, 2007(43 Birthday)
    Posterior T3- L4
    Pre surgery curves
    T-53degrees
    L-38degrees
    and a severe side shift to the right.
    Post surgery curves
    Less than 10 degrees
    Surgery April, 2006
    C4 - C6

  14. #14
    Join Date
    Mar 2008
    Posts
    74

    My insurance plan bites!

    Mine has cost me about 8 grand so far out of pocket. I work for a hospital whose insurance plan is self-funded. Since I did not have this surgery done at my place of employment, some of the charges were considered in-network and paid at 80%, some were in the "wrap" network and paid at 70%, and then some were out-of-network and paid at 50%. It's been a real pain to keep track of who is in what network and who's owed what. I feel like tearing my hair out some days, then I go look at my back in the mirror, and tell myself I can't put a price on looking normal. =)

    P.S. Since I had the original surgery on April 8, with the surgery to fix complications on May 9, the first hospital bill alone was $233,000 and the second was $170,000. Yikes!
    Last edited by trishthedish; 11-28-2008 at 07:38 PM.
    Posterior fusion T5-L1 May 5, 2003-age 43
    Posterior revision, thoracotomy,fusion T2-L2 April 8, 2008-age 49
    Fusion extension C1-L2 evacuation left pulmonary effusion May 9, 2008, age 49
    www.buggfamily.blogspot.com

  15. #15
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    Quote Originally Posted by LynnMarie74 View Post
    ... I have a decent ins coverage from my employer & when I called to ask questions, I was advised that all I will be paying is the 250.00 admit. co-pay for the hospital stay, after that everything is 100% covered...no yearly max. ...
    Girl, that's not decent ... that's phenomenal! I haven't had that kind of insurance in YEARS - and didn't realize it still existed.

    You're very fortunate. Eliminating worry over the financial aspect must be a huge load off your mind.

    Sccrmom, same to you.

    Trish, my employer was self insured, as well. If the timing of when I planned surgery (i.e., if I'd missed open enrollment) and if I hadn't had the option to switch from a PPO/FSA to a HDMP/HSA, my costs would have been at *least* equal to yours. I just got lucky.

    Regards,
    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

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