Author Topic: insurance ending - need input  (Read 5409 times)

nanlt124

  • New Member
  • *
  • Posts: 23
  • learning more everyday
insurance ending - need input
« on: September 18, 2010, 04:15:22 pm »
Hi    i am new and have spent a lot of time reading what everyone has to say.  Thank you all for your input - this has really been an education.   My issue is as follows.  I have an AN 1.9cm x1.67cm right side with sudden hearing loss 08/10/10 and constant noise.  I am seriously leaning towards surgery and will meet with my surgeon and neurosurgeon on Tuesday.   My problem is that my Cobra insurance expires on 09/30 and i have no prospect of gettting any insurance for quite a while.  My employer does not offer insurance and a new job is out of the question right now (plus my income is limited).  So, i want to do this and my doctors are aware of my ins issue.  Does anyone know how my aftercare will be affected by my insurance ending?  Is it usually covered once the surgery is initiated during my elegible time?   I do not want to wait because i do not know if i will have any insurance any time soon and i will also then be considered preexisting.   Any input would be appreciated.  Thanks and Good Luck to all.    nancy in clearwater, fl

CHD63

  • Hero Member
  • *****
  • Posts: 3235
  • Life is good again!!
Re: insurance ending - need input
« Reply #1 on: September 18, 2010, 04:59:20 pm »
Hi Nancy and welcome to this forum of caring, supportive friends .....

I am not an authority on insurance issues, but others will be along soon to share what they know, I'm sure.

In my case I think it was a single charge from the neurosurgeon for his pre-surgery evaluation, surgery, and hospital care.  I had no complications following surgery so I do not know how that would have been handled.  If I were you I would explain the entire situation upfront to your surgeon and I feel certain something could be worked out for coverage.

Best thoughts and let us know what happens.

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

Jim Scott

  • Hero Member
  • *****
  • Posts: 7241
  • 1943-2020 Please keep Jim's family in your hearts
Re: insurance ending - need input
« Reply #2 on: September 18, 2010, 05:26:10 pm »
Hi and welcome, Nancy in Clearwater, Florida ~

I'm not an authority on medical insurance but I believe that once your doctor perform s the surgery (or radiation) the aftercare is included in his fee, but I would get this clear with the doctor or someone on his billing staff.   In my experience, Blue Cross covered all the costs of my AN surgery once I had met my 'out-of-pocket' deductible ($2,500.)  There were no follow-up, aftercare costs.  

It's unfortunate, but in light of the fact that your insurance coverage will be terminated on September 30th, 12 days from today, making a treatment decision and having the surgery, if that is your choice, is imperative.  I believe your AN is small enough to be irradiated, but that is for a physician to decide.  However, as urgent as your decision is, please try not to jump into anything without some real thought as to what you want and what doctor you're comfortable with and feel confident about, because choosing a doctor is crucial.  Please let us know your decision.  Thanks.

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

nanramone

  • Guest
Re: insurance ending - need input
« Reply #3 on: September 18, 2010, 06:46:32 pm »
nanlt124

You can get insurance due to the requirements made in the new health care bill.

http://www.healthcare.gov/law/provisions/preexisting/states/fl.html

Yes, it's expensive. I'll have to buy something similar when my COBRA expires next March. I'll find a way  - it's better than no insurance at all.

Though by then, I may be poor enough to qualify for Medicaid.

Good luck to you.

Nancy

leapyrtwins

  • Hero Member
  • *****
  • Posts: 10826
  • I am a success story!
Re: insurance ending - need input
« Reply #4 on: September 18, 2010, 07:40:22 pm »
Most docs include a certain number of days for followup appts. post op in their surgical fee. 

In the case of my neurotologist I think it was 90 days; I had no followup appts. with my neurosurgeon.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

nanlt124

  • New Member
  • *
  • Posts: 23
  • learning more everyday
Re: insurance ending - need input
« Reply #5 on: September 18, 2010, 07:51:30 pm »
thank you to all who have responded to me     i have felt more at ease since i started reading what you have all been through    i see my surgeons on tuesday and have further testing    will make my final decision as to whether or not to go for surgery or wait   will let you know       nancy in clearwater, fl

leapyrtwins

  • Hero Member
  • *****
  • Posts: 10826
  • I am a success story!
Re: insurance ending - need input
« Reply #6 on: September 18, 2010, 07:52:33 pm »
Good luck, Nancy.  Hope the appointment goes well.

Definitely keep us updated.

Thanks,

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways