Re: Has anyone had excision surgery? I forgot to ask a few more questions?
From: Amber (anonymous@obgyn.net)
Mon Aug 28 14:21:12 2006
Pamela,
I think it is worth trying to get coverage with your insurance. I am
working on that right now with my HMO, they have said I have no out of
network benefits, but I am trying to get in-network because there are no
excision specialists in my area (not that I know of at least). I have
gotten really good information from references from the CEC, they have
helped me so much so far. The whole money and insurance thing really
stinks, because you want the best possible treatment and it seems so
difficult to obtain. I certainly understand your frustrations. In
Virginia, the bureau of insurance provides a service to help you get
benefits that might be denied by your insurance plan. Good Luck!
At Sun, 27 Aug 2006, PAMELA wrote:
>
>1) How long did your surgery last?
>
>2) Were you bedridden afterwards?
>
>3) If you work, when were you able to return to work after your surgery?
> (Basically how much work did you miss)
>
>4) Did you have insurance?
>
> If so, did you have PPO or HMO?
>If you had PPO, did you have to pay anything up front (such as a
>deductible
>& coinsurance if it had not been met) whether your insurance was
>in-network
> or out-of-network?
>
>If you had HMO, did you have problems getting the surgery covered if
>your
> insurance was out-of-network?
>If so, did the doctor & his staff help you with your insurance to try to
> get your surgery covered?
> If so, did they still make you pay money up front?
>
>This is just something to help me greatly decide on if I want to have
>excision surgery or not. I am contemplating having it done before the
>end of the year. The only problem I do not know how much time that I
>might have to miss from work (I have very limited time at my job) & I
>really do not have alot of money to put down for a down payment. I have
>PPO insurance, but most of the good doctors who do excision surgery are
>out of my area (I live in Florida). I have met my deductible &
>coinsurance for this year with my insurance but that is of course for
>in-network doctors. But going to the excision surgeon that I want to go
>to would be out-of-network, which I have not even used any of those
>benefits with my insurance. I have 5,000.00 out-of-pocket that has not
>been met & I think either 600.00 or 300.00 deductible that has not been
>met. Either way I would have to pay quite a bit up front if the doctor
>makes me pay up front. The last surgeon that I went to to do my
>laparoscopy almost made me pay up front too, but I weasled my way out of
>it because I work at a hospital (I was EXTREMELY lucky that time). It
>is sad that these doctors are making us pay our deductible & coinsurance
>up front when we have insurance. That is why we have insurance. And
>many of us who have insurance cannot afford to pay anything up front
>even though we have insurance. It totally sucks. I spoke with some
>people at my job asking if I could somehow get a surgeon & hospital out
>of my area (who would be considered out-of-network) to be in-network
>with my insurance. I was told that it could be done, but it would
>probably have to be extenuating circumstances. That one woman that I
>spoke with said that my problem would not be considered that. That
>really made me angry. I think having Endo & having all the problems
>that we have we all need to have the money to be able to go to the best
>surgeon possible so that our life is bearable. I don't know why someone
>would say something like that. I guess from what she said it is not
>worth me calling my insurance or even writing a letter to get an
>authorization (or referral) from my insurance to make the surgeon &
>facility that I want to go to participating with my insurance (due to no
>good surgeons or hospitals in my area) because Endo is not VERY serious
>at all. I could just punch her out. Well, thanks for letting me vent
>some. Thanks to all of you that have alreay responded. All your
>responses helps greatly.
>
>--
>Pamela
>
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