No insurance coverage

[Wishing]

Lynette, One possible idea. Perhaps you can have your internist or primary care physician write a letter to the case management folks at Humana explaining the need for an experienced, specialized scoliosis surgeon due to the nature, severity as well as the complexity of your condition, and thus it is necessary for you to have an out-of-network surgeon perform this operation and that it important that this surgeon performs a significant number of these complex surgeries on an on-going basis. Insurance companies often give waivers to their restrictions when it is necessary to go out of network to get care, and there is no similarly qualified surgeon in your area. Good Luck.

[Pooka1]

this elective surgery

This surgery was NOT elective for either of my daughters.

Not everyone has a choice.

[LindaRacine]

Sorry folks, but the discussion got totally out of control, so I deleted all of the offending posts (and probably a few that weren't so offending).

[Pooka1]

Sorry folks, but the discussion got totally out of control, so I deleted all of the offending posts (and probably a few that weren't so offending).

I KNOW! dhugger was spinning completely out of control!

[LindaRacine]

I KNOW! dhugger was spinning completely out of control!

Very funny... now behave yourself! :-)

[Shari]

My surgery wasn't exactly elective either. I was told I would be in a wheelchair in 5 years and dead in 10. But they called mine elective, because I decided when and if I had it.

By no means will you EVER find me comparing anyone's surgery with another's.
I guess the smart ass in me made a mistake by using a phrase that may have offended you. That was not intended at all. I was only trying to make a point.

Sorry,
Shari

[Pooka1]

Smart ass is good.

I wasn't offended... just confused. I think some people around here do think these surgeries are all elective and we shouldn't feed their confusion.

[LynetteG]

Hi David,

Yes I've been chatting to Debbie Ordes every day pretty much, we have become fast friends - in fact chatted to her today for quite a long time on the phone. I understand that through Humana - Dr. Moreno told me that out of network both he and Dr. Cronen would work on me at St. Joseph's hospital in Tampa which is what I will probably go ahead and try to set up - unfortunately though it will cost me $16,000 deductible, and then 30% up to $28,000 for the surgery, plus any other hospital costs incurred, so that's $42,000. Anyway, at this point I don't care, I'll just have to set up some kind of payment plan and pay as much as I can afford per month probably for the rest of my life, unless I win the powerball

But thank you for that info, Debbie raves about Dr. Cronen too, so that's been very encouraging to me.

My little sons both cried in my arms tonight because they are so upset at the thought of me being away from them for a week in the hospital, they've never been away from me for more than one night. I just comforted them and told them if mommy's not upset, then they mustn't be upset, and they can visit me every day . It's so hard going through a surgery like this when you're a single parent to two wonderful little boys . Still I'm not the first to do this and certainly not the last. Everyone on here has such brave wonderful stories to relate and are all very inspirational.

Lynette.

[LynetteG]

David - I didn't realize that Dr. Cronen is under the Humana plan? That is fantastic news - thank you! I completely misunderstood Dr. Moreno when he was explaining that I had to use out of network in order to have him attend the surgery too, I thought he meant Dr. Cronen was out of network too. I'm going to call his office first thing this morning and book an appointment if he's under Humana as Debbie Ordes highly recommends him, and I believe from what you've said and others have said he was trained under Dr. Lenke who is an outstanding surgeon right? So definitely - I'll go see him and see what happens from there.

I totally understand how you feel David, with wondering is this the right time to do it or not! And wondering what would it be like in the future if you don't have it now. That's the reason I'm doing it now, because I know I would be severely deformed and in horrible pain later down the road if I don't get this correction now before it goes over 90 degrees. Do you happen to know how fast your curvatures are growing? From what you say with working with the county etc., it sounds like now would definitely be better for you financially, and also better when you're a little younger rather than a little older to get this type of surgery.

Thanks again for your great info - good luck to you!

Lynette.