So happy to find this site - Thank you

[Unregistered]

Really a wealth of information in this forum, I look forward to soon becoming a registered member.

In 1980 (at age 2) I had an ASD/VSD and corrective procedure for pulmonary stenosis. The results were wonderful and in all follow-up testing I have outperformed what is considered the "base" scenario for individuals without any heart-complication history. My pulmonic valve is now severely leaking, however, and although I continue to be vigorously active athletically (I teach kung fu, used to competitively figure skate, etc.), I am approaching replacement. The information I have found here about choice of valve (mostly considering homograph vs bioprosthetic), on procedure (traditional vs port), and on timing of operation have all been so helpful for me that I just couldnt help but stop and issue my thanks to the community.

The only information I couldn't find here is information on costs of different procedures. I am currently evaluating new insurance providers (my old insurance expires in 2 weeks) and it is hard to know what is covered, what expenses to expect, etc. If anyone can give me some feedback in this regard, I would be immensely grateful.

Thank you all,
Gary

 

[Ross]

Hey Gary thank you for the kind words. Membership is free, all you have to do is register with a legitimate ISP email address. I'll be the first to welcome you aboard.

The cost thing is hard to really talk about. As with everything, it varies by location and facility. It can be anywhere from $80,000 to as much as $200,000, there just isn't anyway of knowing, not even a real ball park figure.

 

[Gary]

OK, I registered

OK, I registered

It took me a while since 5 of my 6 email addresses (yahoo, gmail, hotmail) are blocked from registering, but I figured out one that will work and am now a card-carrying forum member.

Thanks for the speedy welcome Ross. Even the 80-200K ballpark is helpful.

Best,
-Gary

 

[Ross]

Short answer-Get the best insurance you possibly can?

 

[hensylee]

I'll be the second to welcome you to this great bunch of VRers.

We have somebody who works in insurance and if that member sees this, will come in. We also have very knowledgeable ones who have experience with insurance issues and will help, too. Just remember that insurance companies consider 'preexisting'. Good luck.

 

[Georgia]

Ditto Ross - you need the best insurance you can find. Are you replacing your policy because you want to, or have they nonrenewed you?

btw - welcome to our little cyber-home.

Ross's guesstimate of cost is good - of course, if you have a ppo or hmo policy, the company won't pay the "retail" cost. That's reserved for the poor folks who have to pay out-of-pocket.

 

[cam4est]

Hi Gary, welcome to the forum! I am new to it myself but it sure is great to hear from folks that UNDERSTAND what you are going through and support whatever you need to know or do. I recently had 2 PVR surgeries, one at a state teaching hospital ($80,000) and the other at the Mayo ($108,000). Of course this is very specific to what you have done, days in the hospital, ect. ect. About insurance. The first PVR was dictated to be instate only but my insurance coverage (a local ppo) and the next one was with Anthem B/C, B/S. Those folks could not have been easier to deal with. It was a ppo policy but they told me that since the Mayo in MN has an Anthem ppo in MN, that they would count it as innetwork coverage. I could have reached through the phone and hugged that woman when she told me that. So as you can see, it pays to carefully check out insurance policies based on where you are going to have surgery. Good luck to you in your searches. Karen

 

[Lynlw]

welcome Gary,
I'm not sure if you are having to chose between different companies or just different plans IF it is choosing plans w/in the same company i really like our PPO, for a few reasons not needing referals is a biggie but also they are pretty flexable about going where you need to go like karen said, we also have a BC and took Justin to 4 different hospitals all out of our state and since they were in their local bc network, we didn't have to pay anything.
It also makes a difference if you are going thru work or indivdual plans since the group thru work won't consider preexisting where if you are getting a non group plan, you may have to stay w/ what you have now to avoid the prexisting insurnace clause.
I agree w/ everyone else get the best plan you can afford, the min you plan on a surgery costing a low amount and hope you will be a textbook case in and out, that could really come back to bite you in the butt so to say. Justin had surgery on a monday was on the floor on tuesday and home on friday for his last surgery (Pv and conduit replacement) I'm not sure what it cost but was one of his less expensive, there is a huge difference in bills for each day you stay in the unit. also you can't just think about what it cost while you are in the hospital, you probably will need cardiac rehab that cost alot and if you chose mechanical, you will have to consider the cost of coumadin, testing and the additional expenses that go with that, (where a tissue most likely won't have the monthly cost that goes against your cap if you have one, but will be another surgery when it needs replaced)
I'm not sure what you/your docs thoughts are on valve choice, but most Pulm valves I know have tissue.
Lyn www.caringbridge.org/nj/justinw

 

[Barbara Stewart]

Welcome to VR.com

Welcome to VR.com

Gary,

Welcome aboard. I'm fairly new to this site. But I'm now hooked. My first surgery, all totaled, was close to $200,000 and my second 8 months later was somewhere in neighborhood of $150,000. I did have major complications after my first surgery and was in and out of the hospital for 3 months so that made it really expensive.

Insurance has become very important to me. I don't know what I would have done without it. My husband lost his job last May and we had to pay for 2 months of COBRA to the tune of $883.00 a month.

Again we're glad to have you here.
Barbara

 

[Gary]

Thanks for the feedback all. In answer to your questions, I am switching from my current carrier to a new one because I graduated from grad school and can no longer stay on the school's program.

Another detail I guess I should have mentioned is that since I am living in China, there are not too many plans/carriers to choose from (and one of the ones I liked the best excludes bioprosthetic valves made with animal tissue). The good news is that the few plans available seem to have pretty extensive US ppo networks (My current favorite plan--International Citizen Platinum--uses both MultiPlan and Hygeia networks) and even more flexible coverage outside of the US (I am considering at least one hopsital in London for my operation). Unfortunately, I am still early in the game and have not yet done my research on where to have my operation. I searched the above networks for the few places I know of (Various Children's Hospitals, the Mayo in MN, the Cleveland Clinic), but if any of you have a minute and want to check if the places you had your VRs are covered, that would be great (hence the links above). Please feel free to private message me.

I'll make sure to let you all know once I am succesfully insured Thanks Again,
-Gary

 

[Ross]

Multiplan PPO has both of my hospitals listed with them.