Author Topic: Anyone from NY have GHI insurance  (Read 8608 times)

Dawn

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Anyone from NY have GHI insurance
« on: February 19, 2009, 01:02:15 pm »
Hi

I am trying to figure out costs and insurance coverages for all the upcoming expenses of having an Acoustic Neuroma.

I have GHI but not a lot of surgeons that perform this procedure accept this coverage. I am wondering if anyone in the NY area has GHI and who they used for a surgeon and what the expenses were.  I am told by GHI that after my $200 deductible is met for office visits they pay a portion of it...like $53-72 dollars worth of a huge bill.  As for surgery...I have $1500 deductible and then after that GHI may pay a small fee for out of network but it won't be much and that I'll be responsible for the rest unless I can find an IN NETWORK doctor to perform the surgery.

I have the list of ENT's that GHI has in their plan and I don't recognize any of them as being top docs in NYC!!!!

Any help anyone can offer would be great....I'm starting to lose sleep over the crazy amount of debt I am about to come into!!!!!!

Diagnosed 12/08...4mm Left AN in IAC...Wait and Watch for now...Next MRI scheduled for 8/09 Doctors not sure if its AN, Lipoma or Hemangioma????

Also diagnosed with Chiari I Malformation - looking into options for that

wcrimi

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Re: Anyone from NY have GHI insurance
« Reply #1 on: February 19, 2009, 05:26:20 pm »
Dawn,

Most of these surgeons work in teams. You may be able to find a team member that is In PLAN that you will be covered for (including hospital stay) and only have to worry about the fee for the other surgeon.  THat's what I did with Smouha (in plan) and Post (out of plan).

Take a deep breath and try to relax. I see that you are still in watch and wait and won't even have an MRI for a few more weeks. So there is time to try to work this all out. Take it one step at a time and don't panic. 
1 cm, 6mm, 4mm on Left side. Surgery performed 11/6/2008 by Dr. Kalmon Post and Eric Smouha at Mt. Sinai Hospital in NYC.
Normal hearing before, 85%-90% now, dizziness when walking or turning head, annoying hissing and high pitched tinnitus on and off, eyes have trouble adjusting to rapid head move

wendysig

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Re: Anyone from NY have GHI insurance
« Reply #2 on: February 27, 2009, 10:24:06 pm »
I was almost certain Dr. Choe accepts GHI and after reading your post I checked -- he does accept GHI HMO and GHI PPO(for some reason he didn't appear in my Physician Directory either but accepted Aetna and is accredited by them. I don't know if my neuorsurgeon, Dr. Chun S. Chen accepts GHI, but I highly recommend him.  He has 27 years experience behind and was named  in Castle Connolly;s Top Docs and t he New Yorker as a top doc this year.  I certainly found him to be a wonderful and caring physician.  It is worth checking to see if he accepts GHI.  If you need their information again, please let me know.

Wendy
1.3 cm at time of diagnosis -  April 9, 2008
2 cm at time of surgery
SSD right side translabyrinthine July 25, 2008
Mt. Sinai Hospital, New York, NY
Extremely grateful for the wonderful Dr. Choe & Dr. Chen
BAHA surgery 1/5/09
Doing great!

Dawn

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Re: Anyone from NY have GHI insurance
« Reply #3 on: March 01, 2009, 10:44:54 pm »
Hi Wendy,

I actually just emailed Dr. Chen, he does accept GHI and does to Mid Fossa surgery.  I was just wondering how he was and haven't heard much about him.  I saw Dr. Post at Mount Sinai and he did not mention Dr. Chen's name when I asked for referral since Dr. Post no longer performs Mid Fossa surgery so that made me wonder.

I am going for my MRI Tuesday and will have my second visit with Dr Selesnick right after that....I will be making some decisions after the MRI results and will be asking Dr. Selesnick about his coverage with GHI and if he accepts out of network payment....

Thanks for getting back to me..
Diagnosed 12/08...4mm Left AN in IAC...Wait and Watch for now...Next MRI scheduled for 8/09 Doctors not sure if its AN, Lipoma or Hemangioma????

Also diagnosed with Chiari I Malformation - looking into options for that

pjb

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Re: Anyone from NY have GHI insurance
« Reply #4 on: October 13, 2009, 03:48:58 pm »
Hi Wendy,

I actually just emailed Dr. Chen, he does accept GHI and does to Mid Fossa surgery.  I was just wondering how he was and haven't heard much about him.  I saw Dr. Post at Mount Sinai and he did not mention Dr. Chen's name when I asked for referral since Dr. Post no longer performs Mid Fossa surgery so that made me wonder.

I am going for my MRI Tuesday and will have my second visit with Dr Selesnick right after that....I will be making some decisions after the MRI results and will be asking Dr. Selesnick about his coverage with GHI and if he accepts out of network payment....

Thanks for getting back to me..

Hi, I would like to know how your visit with Dr. Selesnick went I to saw him....
Diagnosed with a 1 cm. AN had Retrosigmoid
Approach surgery July of 2009, several problems after surgery.

Jimbo

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Re: Anyone from NY have GHI insurance
« Reply #5 on: October 21, 2009, 08:42:31 pm »
Dawn
Hi, I also saw Drs Stieg and Selesnick for consultation about my 7x12 mm AN in early 2008. They each billed me for the visit. I paid the full amounts by check, most of which was reimbursed by GHI.

They referred me to Dr Susan Panullo regarding the G-K option, which I actually decided to do; great results thus far. I don't recall who, but someone on the team accepted GHI, so I had relatively minor out of pocket expense.

Jimbo
7 x 12 mm AN diagnosed April 2008.
Leksell GK performed at Columbia-Presb July 2008