ANA Discussion Forum
General Category => Insurance => Topic started by: sues1953 on February 16, 2010, 08:14:46 am
-
I have done everything SBI has ask and I'm in waiting mode and its making me a little nuts! I'm trying to be patient but I think I will call them today, they have my referral letter from my PCP (I have an HMO), and all my records. I was told that Dr. Shahanian would evaluate my case and then the surgery coordinator would call e to set up a consultation (on the phone), 750.00 dollars :o. Surgery coordinator Eve Ra told me that for HMO's they roll all the cost together so I would not have to pay the 750.00 immediately but i do need to know exactly what all of this is going to cost before I commit.
Has anyone heard of SBI accepting what ins is willing to pay? If they don't I really don't think I have much of a chance of being able to go there. My DR. here charged 350.00 and my insurance paid a little over 200.00 of it but of course that was in network. I was totally upfront with Eva and ask her what my chances were and she encouraged me to go ahead and see if I can get my ins to cooperate. My PCP said it would be 2 or three days for the insurance co to get back with them. This is day 3.
Meanwhile I have a surgery date of March 15th at Michigan Ear Institute for Translab. I have two weeks before I go in for my pre surgery tests, I'm a wreck. I want to call MEI and let them know what I'm doing but my family is telling me to wait. :-\
Anyone out there have advice for me? Any and all is welcome.
Sue in Michigan
-
I know we have messaged back and forth, and I don't really have much advice. But, once again I will tell you I am very happy with MEI. I also can't imagine even if your insurance pays for the surgery at HEI, will it pay for all of your travel too? Plus hotel stay, food, etc.? Just a thought. My surgery was in Novi (the new hospital there) which is 3 1/2 hours away. The great thing there too was they let my husband stay right in the room after the 1st night, so saved lots on a hotel fee. They were great for us and to us.
I wish I could give you better advice, but I know I felt comfort in my decision there right away after researching a few other MI options.
Best wishes still go out to you!!!
Denise (MI)
-
Hi Denise
Thanks for your reply. I have been talking to a few people that had surgery at SBI and that is where I want to go but just found out yesterday that my insurance will not pay. I am starting the appeal process but that will take time as well. Meanwhile I start my pre op appts at MEI next week :-\. I'm pretty sure that I will have to cancel or at least postpone that date. It is making me soooo crazy. :(.
It's not that I don't think Dr. LaRouere is a fine surgeon I know he is and I will go there if Ins won't pay I guess but I have to exhaust all possibilities for SBI first. It's things like....did you know that it take 4 hours of the surgery time just to get the skull open? :o Most complications with this surgery are due to opening the skull and just getting to the tumor. I have read everything I can find on SBI and I feel my time on the table and also my recuperation time will be cut in half. The hearing loss I know will be hard for me but a small price to pay in the BIG PICTURE. I have a large tumor with few symptoms so I expect to return to my normal ( ::) ) life soon after surgery. I am our only income right now and that will be zero until I am able to work again.
My brother (bless him) is giving me his vouchers for our travel and as far as Hotel expense I am just not going to worry about that right now .
I read your posts about Baha surgery and I know that MEI asks for 500 dollars out of pocket and from what I can figure other places get the whole thing covered. Since its not as serious of a surgery you might want to check other options.
Wishing you the Best,
Sue in Michigan
-
O.K., what exactly is SBI???
You do need to go where you feel comfortable. Did you use the search engine here for MEI, Michigan Ear Institute, or the Dr. LaRoue? Pretty sure all are pretty positive.
I have been researching the BAHA & TranEar stuff like crazy the past few days and finding most places ask for that $500 fee, but some get insurance to cover that part. Evidentally it is something to do with Cochlear. Not sure yet. There is actually a doctor in Muskegon (about 50 miles from me) that comes to Ludington twice a month and he is just starting BAHA stuff. Hasn't done one surgery yet, but man.....offered a great deal, of course that would mean I would be his guinea pig with the surgical part. Hmmmm, he does lots of other surgeries and heard good things, but not sure.
Isn't all the decision parts just stressful?? Wishing you the best on your journey!!
Denise
-
I have been researching the BAHA & TranEar stuff like crazy the past few days and finding most places ask for that $500 fee, but some get insurance to cover that part. Evidentally it is something to do with Cochlear.
The $500 fee that some places ask for is for programming of the device, it has nothing to do with Cochlear.
My BP100 is on backorder from Cochlear, but the only thing I'm playing my doc's office for is the device itself; nothing for programming. In fact I'd never heard of this $500 charge until I read about it in a post on the Forum. I think it was Melissa and/or Kathy M who mentioned it (?)
As for a doctor performing his first BAHA implant, I asked my doctor if you should look for someone who has performed lots and lots of BAHA implants (similar to AN surgery) and he told me it really isn't necessary. He said it's a pretty routine surgery, so whether someone's done 3 or 300 it shouldn't really matter. What matters more is that the doctor knows how to perform the surgery.
Jan
Almost forgot, SBI stands for Skull-Based Institute. Dr. Shananian does endoscopic AN surgery there.
-
HI Cheryl
I agree with Jan I wouldn't think that the Baha implant surgery would be "Brain Surgery" and if you are getting a good deal I'd go for it.
Last time I talked to MEI I specifically ask about the 500.00 fee and they said yes that was an out of pocket fee not covered by insurance. I'm sure I will be in the market for a Baha and I will search out a Dr. that includes that fee in what is being billed to the insurance co.
I have done a lot of research on MEI and I am convinced that they are probably the best in my area. I have made several requests for referrals and past patient info and they just don't come through. Everyone here keeps telling me to go with my gut and that's what I am trying to do. I have read positive things here about MEI but if you read closely everyone has had complications, specifically tumor regrowth. I just read of one of Dr. LaRouere's patients having regrowth at her one year MRI and she was told after surgery that the tumor was totally removed. MEI pouts their successes of saving the facial nerve which I agree is Very, Very important but leaving some tumor seems to be the norm. I do understand that their are no guarantees with any surgery and this forum does not represent all outcomes of any DR ,but why can't they help me out with some prior patients?
SBI is as Jan said Skull Base Institute, they do minimally invasive endoscopic surgery. I read that with traditional surgery up to 4 hours of the surgery is just getting to the tumor :o. I believe that my surgery and recovery time will be cut in half by going this route. My tumor is large so my options are few. Dr. Shahanian has totally removed many large tumors with no regrowth while saving the facial nerve.
Good Luck with your Baha research! Keep us posted.
Sue in Michigan
-
OK, I just went back and looked it is KATHY, the same person who had the insurance problems with her BAHA also had regrowth at one year when she had been told that the entire tumor had been resected. Again, I know these things happen but I can only do this thing once (i hope ) :). I don't want to have any regrets.
Thanks for listening!
Sue in Michigan
-
Ahaa, now I know what SBI is. I hadn't found much on that before my surgery when going through all the searching stuff like the point you are at now too.. Have to say 'whew' in a way though because as you know right now it gets overwhelming for sure!!
I say going with your gut feeling is very good. As for all the outcomes, that is where I find this whole AN thing interesting. There are SO MANY factors in such a tiny little area that can make the biggest impact as to how the surgery comes out. The doctor and procedure of course have a big impact, but wow....the actual tumor size, placement, if it is sticky, etc. is the one of the main things too. :-[ So, I think feeling comfort in your heart and gut and just knowing the outcome can very puts your mind at ease.
By the way, are you on Facebook? I seen something on there about the endoscopic surgery. Have to say I looked past it because I'm post surgery, but just another option...???
I will be thinking of you and wish you the BEST for sure!! (Oh just went to post and got your last post.....I LOVE this place for people listening.....even lets people vent when they need to and so many understand!!!)
Take Care,
Denise
-
This is overwhelming! It seems I spend every free moment I have on this forum, I feel at home here and I haven't met one person but sure hope to one day. I took a look at your blog and what a beautiful family you have 8). Its great to have family support, your husband sounds especially wonderful. My husband loves me but he is really unable to be of support to me. His business (auto related) is in trouble and its his life. I know he is feeling a double whammy :'(
Yes I am on facebook but don't get on there much I will take a look for endoscopic surgery. Was it for Brain Tumors?
I will be so relieved when a decision has been made. My insurance denied my request to have surgery at SBI but I'm appealing. Wish me luck and I will keep you posted.
The best to you and your lovely family.
Sue in Michigan
-
http://www.facebook.com/group.php?gid=78633792319# This group is called Acoustic Neuroma Association (ANA). I think started by someone from USA.
http://www.facebook.com/group.php?gid=8190517727 This group is called Acoustic Neuroma Association / Vestibular Schwannoma. It was started by a volunteer from ANA of Canada. It has Many more members, photos, updates, etc.
Here are the 2 links to the facebook pages! Seems like one of them has a Discussion or Topic page that I may have seen it under.?
Suppose you're referring to my blog a & family.....THANKS so MUCH!! I basically started a blog (AND there is Caringbridge) to help keep people informed since I know a lot of people wanted my husband to call them because we were away from home. I use it as more a journal for myself and can look back and see how far I have come! :)
If you need help with the facebook pages, let me know!
-
I read that with traditional surgery up to 4 hours of the surgery is just getting to the tumor :o.
My AN was approximately 3 cms and my surgery only lasted 7 1/2 hours. I don't know how long it took to get to my tumor, but 7 1/2 hours isn't bad for brain surgery.
Jan
-
Well Jan if what I read is true then four hours of your surgery was spent just getting the skull bone off. From what I'm reading with minimally invasive endoscopic surgery this time is cut in half.
Just searching and hoping and praying here ;D
Sue in Michigan
-
Thanks Cheryl for the link for facebook I sent a post to an SBI patient.
Im home today because of the snow, I don't think you are getting it this time, your too far north. My daughter is a teacher and I watch the kids. We love snow days ;)
Sue in Michigan
-
Hey Sue
I had been wracking my brain on this for a couple of days and now remembered what I wanted to share with you about SBI and insurance issues.
Allegro/Laura (who I had the genuine honor of meeting last year at our local NE Brunch), had her AN surgery at SBI... and did a post late last year about some of the whoa's she has unfortunately run into, including insurance issues with SBI.
Here is the latest update she did:
http://anausa.org/forum/index.php?topic=11361.0
I'm not sure if she's been online here lately but she did take the time to share this with us.... and hoping it helps you with your question.
Hang in there!
Phyl
-
Sue, I have to laugh, but do you realize you've referred to me twice as Cherly???? ;D
My profile name is exactly me : Denise
Trust me, I know how confusing it can get with all these people on here.. That is why I kept my profile as my real name.
Take care :)
Denise
-
Sorry Denise :-[ I don't feel I'm working at full capacity these days. Thanks for the correction and the support :-*
Sue in Michigan
-
Thanks Phyl I have read most of Laura's posts and I know that she was recently diagnosed NF2. I thought I had sent her a PM asking what she meant by the "nightmare" that SBI turned into but I can't find it in my posts. I think it had to do with insurance not her surgery. I will PM her again.
Sue in Michigan
-
Thanks Phyl I have read most of Laura's posts and I know that she was recently diagnosed NF2. I thought I had sent her a PM asking what she meant by the "nightmare" that SBI turned into but I can't find it in my posts. I think it had to do with insurance not her surgery. I will PM her again.
Sue in Michigan
Noted Sue... thanks. I/we know Laura has had a most difficult time in the past months (and now with her NF2 diagnosis), so if you don't hear back from her fairly soon, let me know.... ok? :)
Phyl
-
OK Phyl, will do. I know that she is going through an awful time right now. Do you think it would be appropriate for me to contact Pooter, that's who she was directing the "Nightmare experience with SBI" post to? I know I am very impatient these days but everything seems to move sooooo slow. I was trying to get more information about Ins. and what my cost is going to be before I canceled my March 15th surgery with MEI. I had to cancel yesterday because my pre op testing was starting today.
I have been waiting and waiting for Roxy (Clinical Program Director for SBI) to cal me back since last week. Very busy I guess ::). I just feel I should be moving forward at least a little every day.
Thanks so much.
Sue in Michigan
-
Sue -
this might be the link you are looking for http://anausa.org/forum/index.php?topic=8949.0
It talks about SBI and out of network coverage.
Jan
-
Thanks Jan I have read that thread and that's when I started pursuing Steve (seal) his insurance had approved him and 2 weeks before the surgery changed their minds ::). As far as I could tell he did not get to have his surgery at SBI. Laura (allegro17) had the same insurance as Steve, had her surgery and then was stuck with a huge mess that she still battles today.
I just finished talking to Roxy at SBI and she suggested I change my insurance from an HMO to a PPO. I never thought of that because I thought it would be considered a preexisting condition. She told me that with group insurance I can change the only catch is I will have to wait until Oct. 1 because that's the open enrollment time. If I can wait the only thing I have to pay would be out of pocket max probably 500 or 1K. A drop in the bucket compared to the 160K price she quoted me.
Next problem....can I wait that long :-\. I have a phone consult scheduled for 3/4 so when I call to cancel that I will ask if Shahianan can make an educated call on that. He has all my info there. My tumor is large but who knows what rate it is growing. My symptoms are few but It seems like they are getting a little worse. Could be my imagination ::).
I am certainly considering this.
Thanks All
Sue in Michigan
-
Hi, Sue,
I had surgery at SBI and here is my insurance story. When I realized I needed to do something about my AN regrowth (I was W&W for 9 years before that), I had HMO. There were 3 top neurosurgeons available through this HMO in NYC area. After talking to them, I realized that the situation was very difficult and I needed special expertise. I decided to go to House which is out of state and my HMO obviously does not cover. Meanwhile, I was researching SBI and all I could find about endoscopic AN removal. So, either way, I needed to travel to CA for surgery.
At the end of 2006, I changed to Aetna PPO during the open enrollment period. The surgery was now considered out of network (covered at 70% ), the hospital where Dr. Sh operates and the House - in network, covered at 100%. The insurance does not reimburse for travel, lodging and food.
I decided on SBI, my neurologist got a precertification for surgery from insurance company and I had my surgery on June 27, 2007. A few days after coming home, there was a huge article in a local newspaper about Aetna and how it was short-changing consumers. There were two issues: 1) the "reasonable and customary" rate for determination of out of network benefits was laughably low and 2) patient was stuck paying for out-of-network physicians when they had no choice in in-network hospitals, like anesthesiologist, radiologist, pathologist, etc.
Before long, the bills started arriving and they were for thousands of dollars from people I have never even seen. Dealing with insurance company took many unpleasant months and it was a full time job. The bottom line was that I paid only $20K that Dr. Sh demanded from a patient if insurance does not pay the entire amount as well as travel costs to CA. This is just too scary to mention the amount I would have to pay had I not battled the insurance company. The expenses for surgery as well as travel for it, by the way, are considered incurred medical expenses for tax purposes. I wrote them off taxes that year.
The amount the insurance paid plus my $20K was still a lot less than what Dr. Sh charges for surgery but he accepted that amount as a full payment and sent me a letter. I was lucky I had the money to pay, otherwise the cheapest way to have surgery would have been through HMO doctors which did not have the necessary expertise. So, just because you are changing to PPO from HMO, don't assume that everything is covered. The insurance company has a myriad way to deny you benefits. They posted huge profits for last year, didn't they?
Good luck!
Eve
-
Sue ~
I've been following your insurance travails (along with many others, I'm sure) and I admire your tenacity and resolute attitude in finding the best and most affordable treatment.
I just want to join Phyl (in another thread) and Eve (in this one) in cautioning you about 'jumping' from an HMO to a PPO insurance plan in the hopes of getting 'out of network' coverage for endoscopic surgery at SBI. As Phyl suggested, research this carefully and if an insurance company representative tells you something is (or isn't) covered, get their name and telephone extension number 'for future reference'. I mention this because I've had an insurance company rep tell me one thing, I call back and the next rep (you never seem to get the same person) says that is wrong and usually act as if you made it up. Hence, the need to document the date and time you call, name of representative and their phone extension. Never be shy about asking for a supervisor if the phone rep seems uncooperative, poorly informed or just surly. I might add that, logically, the staff at SBI are hoping to obtain your 'business' so they will steer you in a direction that ultimately benefits their institution in terms of securing payment for a surgery, which, as you know, is a substantial amount of money. That isn't necessary devious or wrong, just something to keep in mind when their representative cheerfully advises you to change insurance plans so that their facility will be paid for your planned surgery.
Symptoms can be deceiving and I can't comment on whether waiting another 8 months is medically feasible in your case. Only another MRI scan could determine if your AN is actually growing. I don't envy you this dilemma but I do admire how you're attempting to deal with it. I wish you complete success in your quest for the most efficacious treatment approach at a cost you can reasonably bear.
Jim
-
I'd check out this "jumping" thing more also.
Something just doesn't sound right about it.
I'm hopeful it's the solution you are seeking, but I'm with Jim and Phyl here.
Proceeded with caution.
Jan
-
Thanks Jim,Jan &Phyl,
Point taken, although I feel a little disappointed. I will check it out as soon as I feel better (came down with the flu) >:(. I will let you all know of course what I find out.
Best to all
Sue in Misery :D, I mean Michigan
-
Sue, Go with your gut and keep appealing your insurance with all the paperwork and documentation you can muster up. You really need SBI with the size tumor you have. You don't want to have the facial paralysis or the hearing loss if possible. Go in there fighting.
Mei Mei
-
You really need SBI with the size tumor you have. You don't want to have the facial paralysis or the hearing loss if possible.
Surgery @ SBI does not - and will not - guarantee no facial paralysis and/or hearing loss.
Jan
-
You really need SBI with the size tumor you have. You don't want to have the facial paralysis or the hearing loss if possible.
Surgery @ SBI does not - and will not - guarantee no facial paralysis and/or hearing loss.
Jan
Hi Mei Mei
Jan's point is to also be taken. As with any medical procedure (regardless if AN, GYN, etc), there are risks involved with all medical procedures and it's up to each and every one of us to weigh out all risks involved for our own particular AN journey... Facial Paralysis, hearing loss, etc prevention cannot be guaranteed by any AN treating facility, including AN treatment options offered at SBI, HEI, Stanford, Barrows, MGH, etc., regardless if surgical or radio. If any treating facility/doc notes a "guarantee", I would highly suggest running in the opposite direction.
Thanks.
Phyl
-
Point well taken, thanks Phyl.
Mei Mei
-
Hi all,
I do understand that SBI gives no guarantees my reason in wanting minimally invasive surgery is just that, not as invasive therefore recovery time and hopefully complications are less. That being said I have pursued that avenue to exhaustion. I don't think that I can afford the price that they charge unless my Insurance will cover it. I am still checking out the PPO thing but really don't think I can wait 8 months for surgery.
We had a death in the family (hubbies Dad) so it forced me to take a small break from my dilemma. I canceled the 750.00 consult with Shahanian and have decided to consult with Dr. Telian at U of M. I am so much more knowledgeable than I was when I consulted with Michigan Ear Clinic, thanks to all of you :) I will have a lot more questions, including waiting 8 months. Although I know, because we have no idea how fast this thing is growing, it probably won't be advisable.
Then I will decide who will do the surgery and when :-\. Do you guys think it's OK to call MEI and ask them which Dr. does the most AN surgeries with the least complications, or the best success? Just how would I word that ?
Thanks so much for all your help. (Jan I PMed you last week did you get it ???)
Sue in Michigan
-
Do you guys think it's OK to call MEI and ask them which Dr. does the most AN surgeries with the least complications, or the best success? Just how would I word that ?
Sue, first and foremost... my condolences to you, your husband and family for your loss. My thoughts, prayers and wishes are with you all.
As to your question above... "In a New York minute" (ie; pretty darn quick) I would ask... and how to ask? Just as you noted in your question here. Which dr's have done the most AN surgeries and please advise success rates, what complications their AN patients have run into post surgery and can you speak to any of their AN post-surgical patients for patient to patient reference?
Phyl
-
Point well taken, thanks Phyl.
Mei Mei
no biggie, Mei Mei :) Phyl
-
Thanks Phyl, I'll do it ;D...........Sue
-
Thanks Phyl, I'll do it ;D...........Sue
Hey Sue, do what you feel is best for you... I can only "suggest" and "not tell you" what to do...... my opinion is that by doing such, you will obtain add'l answers you seek.
Just my 2 cents.
Phyl
-
Sue, I am SO sorry to hear of your loss and your husbands feelings right now!! I hope you are doing o.k. since I know your brain is already on major overload with this AN journey. {Thinking of you often!!}
There is another new member on the forum that was asking about U of M and they are from Jackson, MI.
Was wondering if you seen a dr. at MEI yet and if so who?? From what I remember Dr. Kartush was the #1 experienced there. They work with the neurosurgeon Dr. Daniel Pieper from Michigan Head and Skull. His bio on that website says he focuses on AN's a lot. He does surgery and radiation. My MEI doctor was Zappia and that is who I was referred to by my ENT. I had spoke with one in Grand Rapids and Midland and chose MEI. Honestly, I didn't do as much research ahead of time, but I felt comfortable where I was. It is good that you have been on this site awhile before, but it also can be overwhelming due to all the information you can get.
As for me, I knew due to the expense of the surgery, expense of travel, having kids ages 9 1/2 & 11, and knowing there were skilled doctors here in MI, plus knowing the #1 factor that I kept being told too was every situation is individual and where & how the tumor is plays the biggests factors, I never had the thought of leaving the state.
Hopefully when you make your calls and get some of the anwers you are looking for, your heart and mind will guide you in a comforting decision.
Take care,
Denise
-
I had my AN surgery by Dr. S at SBI on 12/15/10 and have had wonderful results so far. I was only in the hospital 2 days and then stayed in a hotel for a week before flying home. I have no facial problems or headaches.
Insurance - I figured I would have to pay the maximum amount for year no matter where I went. SBI negotiated with my insurance company to get the amount I would have to pay reduced. They explained the difference in the days in the hospital and intensive care, etc. with the traditional surgery. My hospital bill was $575.00 (I had a private room). I have not gotten a final bill from SBI yet. I was not required to pay anything up front. They waived the initial consult fee when I scheduled my surgery.
Deciding what to do is the hardest thing. I am very happy with my results. I stayed at Thousand Oaks Surgical Hospital and it was wonderful. The physical therapist that worked with me in the hospital and at my hotel for the week I was in California was great. I was back at work by Feb. 8 on light duty.
I will say that SBI is a very busy office so keep calling and insist on speaking with Roxie or whoever is handling your paperwork. Sometimes it is the insurance company that delays things. Call your insurance company and find out what the maximum you would have to pay in one year. I decided it was worth it. To save money both my husband and I used credit card miles to buy our airline tickets and also had enough for 2 days in the hotel and got lunch at the grocery store next to the hotel.
-
Marsha,
This is great! It is quite a change from what I had to pay. My initial consult was $600 and the surgery cost me $20K out of pocket. Negotiating with insurance was a nightmare and I had to negotiate all other fees (anesthesiologist, pathologist, radiologist, genetic testing, etc.) My hospital was also different: Brotman in Culver City. I have no idea how it compares to Thousand Oaks but I stayed at NYU for my first surgery in 1988 and liked Brotman many times more.
SBI's ability and willingness to work with insurance companies certainly eases financial aspect of this surgery and makes it competitive to other places closer to home. I actually contacted some local neurosurgeons whose name never appeared on this board and they don't accept any insurance. The surgery would be much more expensive with them.
I am thrilled with your outcome. Continued wellness to you.
Eve
-
(Jan I PMed you last week did you get it ???)
Sue in Michigan
Sue -
I did get your PM, just haven't had time to respond. The weekend was kind of my children's birthday (no 29th in February this year - so the celebration lasted Saturday, Sunday, and part of Monday). And I had issues getting onto the Forum - something to do with server problems. Today's the first time I've been able to log on.
Will respond to your PM soon - hopefully this evening.
Jan
-
Thank you all for your condolences concerning my father in law. The funeral was beautiful.
Denise I saw Dr. LaRouere at MEI, I liked him OK, a little dry for my taste and not a wealth of information, although I did get pamphlets from the wall in the office. I do have to say I had just been diagnosed and didn't have a lot of questions t that time. I did call the office a few days later to try to get connected with past patients and I had absolutely no luck with that. I have since talked to people here like you who have had surgery through MEI. I had surgery scheduled for March 15th and just canceled it last week. I was/am persuing Skull Base Institute in CA. I am trying to get up the nerve to call the office and ask who of all the Dr's do the most AN's and has the best success. I am a little afraid of how they will handle that question ::)
Marsha, thanks for your success story about SBI. I find it interesting that your cost seems different than I was just quoted last week. They told you that your out of pocket would be no more than 20K? They wouldn't tell me that at all. It could be just the difference in our Insurance. I have an HMO with no out of network coverage. I am in the process of appealing that. Roxy did suggest that I wait until open enrollment and change my insurance to a PPO but that's 8 months away :( Do you have a PPO now? She also told me that the cost is generally 160K includes everything, barring no complications. I am not putting a lot of hope in my insurance paying the whole thing. I do have an out of pocket max of 1,000 but that's in network. Even 20K is out of the question for us right now.
On a brighter note I made an appointment with Dr. Telian for March 9th for a second opinion. I am excited to ask him all of my well rehearsed questions. :)
Sue in Michigan