Jaw surgery, the entire process, is one giant roller coaster. I've been an epic slacker when it comes to this blog lately, mostly because I've had a number of issues to struggle with, come to terms with and move on from. I'lll do a backlog update next posting. I hope all my jaw buddies who I've been following for months and months are making good use of their smiles and new bites :o).
Tonight I've reached a huge wall, or at least it seems that way to me, with regards to this whole process. I finally got authorization from insurance for my surgery (hooray, right?) Wrong. Wrong. Wrong. They claim that my jaw surgery should cost *drumroll* ................ $1200. That is what they will pay towards my procedure. There is nothing I can do, besides maybe harass the insurance commissioner in *hopes* that they will pay more, but I've heard this will most likely, yield nothing.
Now who should I be mad at, my surgeon's office charging insane amounts for surgery, or the fickle insurance companies refusing to help the people they claim to serve.
Now for those blessed and lucky to have the NHS or other government based program that will cover your procedure, count your lucky stars. Jaw surgery, on average, in the US is $15-70k, seriously. How do surgeons honestly expect people to pay for this. I hate to sound vitriolically negative, but why oh why are you charging such absurd amounts. Aren't physicians and surgeons in their profession, to improve the quality of life of their patients, alleviating them of their symptoms and misery? It seems insensitive and truly inhumane at best, especially for patients who need a procedure and cannot afford it. It baffles and upsets me.
Might be the fault of the mercy ship I watched on 60 minutes (please watch, it will warm your heart)
Mercy Ship, The world's largest civilian hospital ship travels the west African coast, restoring sight to thousands and bringing smiles to faces once disfigured by tumors.
That puts it in perspective.I finally received the go ahead that I am FINALLY surgery ready, ready to book and get this process going. I should be celebrating, be festive and merry, but instead I am overwhelmed with guilt and anxiety. Besides running into a financial problem, my insurance is set to expire end of may, this year. Which gives me 80 days or less to get this lined up, and just discovered this evening, my surgeons office only has 2 open days remaining within my window. I believe if I walk away from this, no other insurance will deal with me, because it will be considered a 'pre-existing condition'. I am besides myself with what to do. Should I take heavy loans to cover the procedure? Should I forget jaw surgery all together and beg my orthodontist to put my humpty dumpty teeth back as they were? I dont know what to do...
If you have any advice or suggestions on what you would do, I'd love to know.
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Long Overdue Update
3 years ago
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Uggg. That is absurd. My advice is to try to negotiate with your surgeon and hospital. In my own experience, my surgeon charged the insurance company almost 19k, but when all was said and done he was only paid about 4600 (3200 by insurance/1400 by me). Obviously, our whole system is broke, because the hospitals and doctors inflate their bill bc they don't expect to get paid the whole amount. Uninsured and barely insured shouldn't have to carry the burden.
ReplyDeleteI listed all my bills on my blog post about it. (http://bracefacethesequel.blogspot.com/2012/12/cost-of-surgerysit-down.html)
My whole surgery (docs/hosp/anesth) was billed out as 70k, but only 17k was paid by my a combination of me and my ins co.
Do you know if your insurance company has a "maximum out of pocket" for you? That means that you are only responsible for a specific amount of the bill. For me it was 5650, which is the only amount I was responsible for after the insurance company paid their portion...
Anyway, I hope this helps and good luck.
Amanda, thank you for your advice and kindness with such a sensitive subject. I completely agree our system is broken, and stands to benefit few at the expense of most. Physicians/surgeons overchange, insurance underpays, and the insurer gets screwed out almost every time. Some surgeons will not even deal with the insurance all together because its too much hassle. I wish it were more balanced, but I'll go and read some of the billing info on your blog, hopefully it will help.
DeleteThanks again xo
Suzie,
ReplyDeleteThis is such a shitty spot to be in. I hate how things work in the states and that you guys have to go through all this crap with insurance. I seriously wish you could just come move here to Canada and not have to worry about something that should be covered under insurance completely. I didn't even have any questions asked here because they look at it as a medical necessity.
Let me know if you're free to chat sunday night, i finish my last midterm and I miss you.
We have to play with the cards we have been given, and these are mine. I wish I was in the UK or Canada and didnt have to carry the weight of the finances, its already heavy emotionally, psychologically etc etc. Im glad we caught up a few days ago, thank you for being an awesome friend.
DeleteTalk to you soon :) x
Hi Suzie,
ReplyDeleteThat really sucks. I forget how lucky we are here in the UK. It may be completely different here but I used to work for a private surgeon and in the UK there are surgeons that charge insurance company rates (i.e. every procedure has a set price and surgeons can chose to charge that price or inflate their prices). Is there anyway that you could swap surgeons to one that is prepared to work within insurance company rates? Again, may be different here in the UK.
Best of luck with it all. It would be a shame to cancel the surgery when you have been building up to it for so long!
Becky
Rebecca, thanks for the advice! I've been working with my current surgeon for 16 months so far, and every surgeon wants things set up 'how they want it'... I could technically find my way to new surgeon within my insurance, but considering I have less than 3 months till it expires, it probably would be very difficult. I KNEW going into it with this surgeon it would be expensive, BUT I assumed my insurance would carry some of the weight instead of leaving me to drown. I'll figure it out hopefully. How far along are you? Hope you are well :)
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