acr
Well-known member
Scary numbers here. I have to admit I have no idea as to the cost of OHS. I stupidly assumed 25K give or take, clearly I'm way off the mark. Thankfully I paid zero.
Medical costs
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There appears to be a huge variation. The hospital billed my HMO $66,000 out of which they paid $51,000 + a few separate charges (about $2000). I thought that appeared cheap for the three procedures they did to my heart (see signature), and a week's hospital stay. I paid $250.
Philip B
Well-known member
High Share
High Share
Lyn,
One would think that a school district would have a better insurance plan, but mine doesn't. Since escalating insurance costs are a constant problem, my district opted to purchase a lousy plan because the superintendent figured if our insurance was lousy fewer employees would use it; fewer claims would result in lower cost to the district.
Initially, our insurance company refused to pay for anything related to my AVR surgery because it deemed the surgery as elective. The fact that my worn out valve was still working and my 5.8 cm aortic aneurysm hadn't blown made my surgery elective. Staff from my surgeon's office had to engage in considerable effort to get me coverage.
It's a sad statement, but we actually seriously discussed taking our chances with not having my valve or aneurysm fixed because we couldn't afford it.
Disagree if you like; Obamacare...I'd take it.
-Philip
High Share
Lyn,
One would think that a school district would have a better insurance plan, but mine doesn't. Since escalating insurance costs are a constant problem, my district opted to purchase a lousy plan because the superintendent figured if our insurance was lousy fewer employees would use it; fewer claims would result in lower cost to the district.
Initially, our insurance company refused to pay for anything related to my AVR surgery because it deemed the surgery as elective. The fact that my worn out valve was still working and my 5.8 cm aortic aneurysm hadn't blown made my surgery elective. Staff from my surgeon's office had to engage in considerable effort to get me coverage.
It's a sad statement, but we actually seriously discussed taking our chances with not having my valve or aneurysm fixed because we couldn't afford it.
Disagree if you like; Obamacare...I'd take it.
-Philip
Yes, I always find it interesting that OHS is considerred lective, as long as you can schedual it and don't end up being operated on following going to the ER.
Did you realize your plan was so bad when you started working their? We have good insurance thru my husband's work,(and had it threw mine before I got disabled) but I know it is expensive, because when we had to use COBRA for a few months, we had to pay over 1300 for the 3 of us.
My husband actually quit his great job (roadie for major bands) to get a job that had good insurance and to be home a little more often .
B
Bridgette
My surgery and hospital stay cost almost $50,000 NZD, of which Southern Cross (insurance) paid $30,000 and I had to pay $20,000....meaning a bank loan plus a handout from my parents.
river-wear
Well-known member
It's open enrollment time and I found that our insurance (through my husband; my job doesn't really have medical coverage available) deductibles have gone up. Going to sign up for the "premium" plan for an extra $1k per year in payroll deduction to get a $2k break in the maximum out-of-pocket expenses. As long as I stay in network, the surgery should be $1500 (in addition to the $2700 we'll be paying for the health insurance).
What I find bizarre about health care in America is how the "list price" for procedures will be well into the six figures and then the insurance company's discounted price will be, say, 30% of list. So the poor folks with no coverage pay list price...
What I find bizarre about health care in America is how the "list price" for procedures will be well into the six figures and then the insurance company's discounted price will be, say, 30% of list. So the poor folks with no coverage pay list price...
Bridgette why did you have to pay for surgery and be 20k out of pocket when there is a national health system in NZ that you can access as a New Zealander?
wcasey5
Well-known member
Mine was at St. Josephs, about 45K. I would think if any place would be expensive, it would be Baltimore with Johns Hopkins, union memorial, and all that. I really wish my share was $100 though! I've had 2 other people tell me their share was around the $100 mark, in the 90's and early 2000's.
You are right, something is weird!
Unless they negotiate with the care providers.
When I had United HealthCare, it would not cover a colonoscopy unless it was a DIAGNOSTIC one. Even though I had a family history of colon cancer (mother & grandmother) and had a personal history of polyps on a previous c-scope. I pleaded with UHC, and was told that the contract with my company's owner covered only diagnostic c-scopes. The gastroenterologist's office would not resubmit it for precert as a diagnostic procedure. However, it did tell me that since UHC would not cover it, they would only charge what UHC would pay had it been covered.
I waited two years until we went with Aetna, which does cover screening c-scopes.
So I do think consumers can strike deals with health care providers to pay less than the full price.
susiesknight
Active member
My BC/BS insurance allowed me to go to UAB(which the surgeon and hospital were "in network" so less deductable and no copay) and they didn't have any imput about valve choice. The total cost was over 100k but due to using the prearranged agreement between BC/BS and UAB, the final charge for everything was 27k. I had a 3k yearly deductable which I met via my heart cat scan/surgeon visit. The good thing is that post surgery(3/11) all doc visits, rehab, meds, general check-up, blood work, cardiac psychologist sessions, eye exams for glaucoma/drussen, dexascan, etc. were all covered and will be until 12/31/09. I had little or no waiting time from diagnosis to surgery although my condition wasn't an emergency and could've been put off for 6 months to 2 years according to the cardio doc but two different surgeons said not to wait more than 6 months. After the surgery, I was told that it was the opportune time due to the actual opening of the aortic valve. I like my current health savings account insurance plan that gives me a tax break for putting money into an account to cover my yearly deductable. It also helps me be more cognizant about the cost of medical fees.
AVR and graft for thoratic aorta aneuryisms
22mm Medtronic freestyle bioprosethic valve
UAB DR. David McGiffin
Birminham, Al
3/11/09
AVR and graft for thoratic aorta aneuryisms
22mm Medtronic freestyle bioprosethic valve
UAB DR. David McGiffin
Birminham, Al
3/11/09
Hank
VR.com Founder, Now just a Member
$200k in 1999
$200k in 1999
My mechanical aortic valve replacement in 1999 was a bit over $200,000 if I remember correctly.
My portion was my $50 co-pay for the hospital visit.
My insurance was Cigna at the time. Crappy job - Crappy employer - and what was generally thought to be crappy care through Cigna..
But yet - Here I am 10 years later - with no complications - so I guess $50 was a screming deal then.
$200k in 1999
My mechanical aortic valve replacement in 1999 was a bit over $200,000 if I remember correctly.
My portion was my $50 co-pay for the hospital visit.
My insurance was Cigna at the time. Crappy job - Crappy employer - and what was generally thought to be crappy care through Cigna..
But yet - Here I am 10 years later - with no complications - so I guess $50 was a screming deal then.
i doubt nationalized health would push mechanical valves. we in the usa
are generally short-term planners. our time horizon is going to be this
fiscal year, or at most the next election cycle.
we want to cut expenses NOW. any effect on future expenses is a problem
for the next administration.
so any push would be for tissue valves to save the cost of anticoagulant
drugs, testing, home machines, etc. tissue valves would be much cheaper
for the program administrators in the short term (assuming the same
installed cost).
oops. that's assuming the mechanical valve companies aren't making
big donations to congressional election committees.
***oh, yes. bryan....the curry at the hospital in chennai was excellent!!
are generally short-term planners. our time horizon is going to be this
fiscal year, or at most the next election cycle.
we want to cut expenses NOW. any effect on future expenses is a problem
for the next administration.
so any push would be for tissue valves to save the cost of anticoagulant
drugs, testing, home machines, etc. tissue valves would be much cheaper
for the program administrators in the short term (assuming the same
installed cost).
oops. that's assuming the mechanical valve companies aren't making
big donations to congressional election committees.
***oh, yes. bryan....the curry at the hospital in chennai was excellent!!
