How Much Does it Cost?

[YankeeBear]

Does anyone have an idea of the approximate cost of AVR surgery,including the major pre-surgical and certainly post-surgical issues?

A reasonable ballpark figure is all I need.

 

[maka]

My mitral valve repair cost about $102.0M everything included and most of it was paid by Medicare and a small part by private insurance...actual cost to me about $700

 

[Philip B]

Cost

Cost

Last March, I had AVR surgery which also involved an aortic graft. Total bills so far are in the neighborhood of $275,000.00. My wife has kept a detailed record of all bills associated with my surgery. It was a sobering realization that my St. Jude implant cost more than many new cars do.

I believe we've had to pickup about about $8,000.00 of that total. This includes payment of deductables and expenses our insurance company refused to cover.

The total bill figure is somewhat deceptive because many insurance companies do not actually pay what doctors and hospitals bill.

As others respond to your question, you'll undoubtedly see a fairly wide range of ballpark figures. Someone once told me that concerns about the cost of AVR surgery was a secondary issue. The most important thing was to get the problem fixed and worry about how much it cost as well as how to pay for it later.

-Philip

 

[tobagotwo]

Philip's seems quite pricey. He should check for double-billing. You can do a search for this, as it's been discussed before.

My recollection is that they usually range from $125,000 to $175,000, but it may be flawed.

Best wishes,

 

[Susan BAV]

Prices are difficult. Doctors and hospitals billed a huge amount and the insurance company came back and said, "No, we are only contracted with you to pay this amount." That amount was considerably less than the billed amount. But I have filed all my papers and don't recall the ballpark figures well enough to say what those amounts were.

 

[sknydave]

Mine was about $166k

Total amount paid by the insurance was in the $75k range. The insurance companies are going to pay much less than any of us would if we are self paying.

 

[Phyllis]

As I remember, Dick's bills were a little over 100,000 after Medicare cut them back. We were out of pocket about $1700.

 

[YankeeBear]

Thanks

Thanks

Thanks, folks, for your responses...

(This forum is a little treasure island, isn't it? I've already learned so much...)

I'd heard the figure of $100K, and your responses confirm it.

Without going into the detail of it, I'm just looking at the broad range of options... I'm currently insured, unemployed, now have a "previously existing" condition....and there's another wrinkle to the story too...

My diagnosis is but two weeks old... I've had the initial echocardiogram, and had my first exercise stress test last Wednesday. The stenosis is "moderate", and that's pretty much all the cardiologist would say without revieiwng the data and the pictures.

So I'm just now hopping aboard the AVR train...

Blessings to all who have gone before me...

Yankee Bear

 

[ALCapshaw2]

I highly recommend that you get Copies of ALL of your Test Reports. HIPPA requires that Doctors and Medical Care providers make copies available to patients. There may be a copying charge.

'AL Capshaw'

 

[YankeeBear]

I highly recommend that you get Copies of ALL of your Test Reports. HIPPA requires that Doctors and Medical Care providers make copies available to patients. There may be a copying charge.

'AL Capshaw'

Thanks, Al. Good idea...

When I went in for the CT scan of the head (to rule out stroke), I asked the nice technician if I could get digital copies for my blog (I've often been told to have my head examined...), he just laughed.

When I asked the nice technician if I could get an audio CD of the swooshing pulsations of my carotids on ultrasound to meditate by, she looked at me like I was weird.

Right now, I'd be happy with a 5-minute conversation with the cardiologist.

But I'm a patient...so I'll be patient.

 

[briansmom]

FWIW, we got digital copies of my son's echos and ct's. They were very cool, you just clicked on them and you were actually watching the echo, so maybe your tech just doesn't realize what is available today. Good luck with everything; it sounds like you have a lot on your plate.

 

[gageyk]

I just had surgery a month ago, So far my bills are as follows:

Billed - Claims Paid - My Cost
Cartoid Echo $375 $0.00 $264.50
Pre-Tests $1779 $786.32 $138.76
Surgeon $11815 $9038.47 $1595.03
Assistant Surgeon $11815 $867.25 $408.77

Anthesiologist $5440.00 PENDING

Nothing from the hospital yet. I did not have a cath. I had one 2 years ago. Pre tests include Chest X-ray, Chest cat scan(not normal), blood work, and pulmonary testing.

My insurance is Anthem of Nevada with a $1000 deductible and a $3000 max annual out of pocket.

For my post surgery INR testing I have to pay $0.35 insurance pays $2.01.

Rx=Coumadin $4.00 per month. Vicodin $8.94 for a 2 week supply. I will update as I receive more bills.

 

[DeWayne]

I asked my wife about this a few weeks ago. She said with cath, cardio, surgery and all it came out to about $105,000. All but $500 was paid for by blue cross blue shield. Emory took care of getting all required oks from the insurance company ahead of time. Made it very easy on us.
I of course had gotten a extra policy from AARP before hand. They paid for time in ICU and hospital, covered about $2500 as I recall. So it more than covered the deductible. Not bad for $35 a month.

 

[catwoman]

My MV replacement (St. Jude) with 1 week in the hospital 4 years ago was about $102,000-$105,000, I believe, including surgeon, anesthesiologist, tissue pathology, etc. My co-pay was $100 for hospital room.

My husband's MV repair in May 2007 was I think $83,000. His co-pay was $500 for hospital room ($100/day, max co-pay was $500). Insurance paid $38,000, I think.
Don't remember what his surgeon, anesthesiologist, etc. charged.

I can't imagine an AVR costing $275,000, unless there were complications & an extended hospital stay, or subsquent hospitalizations after discharge.

 

[DeWayne]

Thanks, Al. Good idea...

When I went in for the CT scan of the head (to rule out stroke), I asked the nice technician if I could get digital copies for my blog (I've often been told to have my head examined...), he just laughed.

The cardiologist gave my wife pictures of my aneurysm from the cath. She had that darn picture inside the clear plastic cover of her notebook. Everytime I looked I saw that darn picture!

 

[67walkon]

Including the pre-surgery cath to make sure my coronary ateries were okay, and also including an extra 5 days in the local hospital when I got home from surgery, the bills are right at $200,000. That was for the valve, the aortic graft and a maze procedure.

My out of pocket has been around $3,000, not including what we paid for my wife to spend a week in Gainesville while I was in the hospital.

I didn't total up what BCBS actually paid. It is an interesting issue in the health care industry that each insurance company negotiates it's own deal with the providers and the hospitals. The bills are pretty standardized, but the payments aren't. There are something like 115 different insurance companies dealing with a hospital I am involved with and each of them may pay a different amount for the same procedure.

John

 

[PeggyM]

The bill from Summit to Kaiser for my cath is $14,890.34. Kaiser does their heart stuff there so I really don't know if I'm going to have to pay something for this or the upcoming surgery. Have any other Kaiser patients had to pay for part of their OHS?

Here's a nice story:
I didn't have insurance when the first mechanical valve failed. I was lucky enough to be brought to Seton, who wrote the $165,000 bill off. And the surgeon, bless him, wrote off his $11,000 bill. Same with almost all the other docs. I though it was remarkable.

 

[Philip B]

Double Billing??????????

Double Billing??????????

Yes indeed, the total bills for my surgery seem pretty high. That $275,000.00 is the total of the bills for expenses (pre-op stuff, hospital, surgery, doctors, specialists, post-op stuff, rehab program, meds, and a home INR monitor) associated with my AVR surgery. Nothing was double billed.

I believe one of the other posts probably communicated the stuff about insurance companies not paying the total costs billed by the doctors and hospital. I tried to mention that in my post, but I probably did not communicate that well. In other words, my total bills add up to around $275,000.00, but you can bet my insurance company has avoided paying costs that are over their contract limits.

-Philip

 

[catwoman]

Yes indeed, the total bills for my surgery seem pretty high. That $275,000.00 is the total of the bills for expenses (pre-op stuff, hospital, surgery, doctors, specialists, post-op stuff, rehab program, meds, and a home INR monitor) associated with my AVR surgery. Nothing was double billed.

I believe one of the other posts probably communicated the stuff about insurance companies not paying the total costs billed by the doctors and hospital. I tried to mention that in my post, but I probably did not communicate that well. In other words, my total bills add up to around $275,000.00, but you can bet my insurance company has avoided paying costs that are over their contract limits.

-Philip

Philip:

Don't think we're all comparing apples to apples.

What was the hospital bill + surgeon's bill + anesthesiologist + any pathology? (No pre-op, no post-op after discharge, no rehab, no meds, no INR, etc., etc.)

If I totalled all medical expenses starting with the car accident that forced my husband to have MV surgery, his expenses would have far exceeded the $83,000 that the hospital billed to BC/BS of Texas.
(We'd also be throwing in the cost of new car!)

 

[Johnny Stephens]

My surgical event, including labs, cath, doctor/surgeon and hospital fees came to ~$165K, parts and labor.

I've never bothered to add up the events since, such as followup visits, Coumadin and testing, Pacemaker, 2 cardioversions, etc. Probably even more.

Just doing my part to support the economy.