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THR FINALLY!!! Cynthia777's Recovery Journey

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@Krista and @Zelda
The lowest out of pocket policy with Blue Shield of CA was the $4,000. I was so shocked when I saw the letter! Of course, Blue will only allow a fraction of what the hospital is billing. Health care costs here in California are outrageous! My stem is titanium, isn't titanium expensive? :heehee:
 
Having lived in the US (California) as well as in the UK I am constantly in awe of the NHS here. We have gold standard care here and no one ever asks us to take out our wallet.

@Cynthia777 your insurance will negotiate that bill way down. Just sit tight - as I recall there was always a massive bill sent followed by something a bit more reasonable. But then again, there is still the surgeon's bill to come. :yikes:
 
@Jaycey...AND the anesthesiologist and my primary doctor and and and!

Fortunately when I hit age 65 Medicare kicks in and the I only pay for supplemental policies which will run about $200 per month (or who knows how much if Obamacare is overhauled).
 
@Cynthia777- Yikes that bill is super scarey! :rolleyes: If the insurance is going to knock it down, I wish they wouldn't just willy nilly throw that horrendous number at you and then tell you they're sitting on it for awhile. Awful awful! And you pay mucho for your health insurance! I hope it all works out to a reasonable amount in the end.

On a brighter note - YAY! You are ready to go get this second hip done! The end is in sight my friend! So happy for you. I'm hoping this next recovery is even better than the last one. You are lucky you are getting anterior again with the same surgeon. That should bring you some peace of mind. (You won't have a new surgeon who sneaks a posterior approach on you without telling, like my lovely 2nd surgeon did. Grrrrrr... :hissy:)

Again, so SO happy for you!
 
@Cynthia777
The health care costs in the US are outrageous & seem to be so controlled by the insurance lobbyists. I know so many here are against a national health care system but I think they don't realize that those of us who have insurance pay for those who don't & the end result is many people are left out and don't get any health care or substandard health care that may end up costing us all more. The substandard healthcare is certainly not fair to those who receive it. Ok, I'll get off my political soap box now.
Cynthia, I too am sure your insurance company will work to negotiate that down. In the meantime, I hope you don't let it distress you much, just be your advocate & keep questioning.
@Readysetgo How disgraceful that your surgeon did a procedure you hadn't discussed! I'm sorry to hear that.
I chose the posterior for a variety of reason but now almost wish I had chosen the anterior simply because I have to wear lace up orthotic shoes all of the time for a foot problem & have to depend on my husband to get them on & off. He doesn't mind helping me; I just have an independent streak. Of course my wishing is neither here nor there. On the positive side, I know I am doing very well & am thankful.
Have a great day!
SweetPea69
 
@Cynthia777, the policies that are supplemental to Medicare for those 65 and older are not connected at all to any provisions in the Affordable Care Act (Obamacare), so no worries for you on that account. Yes, the amounts will go up, but slowly, nothing dramatic. My sister is in that situation now, and did have a policy previously (before age 65) with the ACA, so I have done lots of research on it. My husband is still working, and we still have insurance from his job. Soon he'll retire, and I'll be checking it all out for us. Not looking forward to it!
 
I think this is cruel of insurance companies to send out letters like this that just leave you hanging! You can look at your EOB (Estimation of Benefits) and see how it's being billed out. Hospitals and Drs. can bill out whatever they want but if they're in network, there's an allowance they agree upon with the insurance company. I think other countries make out so much better than we do when it comes to healthcare. Granted, our taxes would probably go through the roof but in the end, less stress on everyone. I just had a friend here and we were just discussing the healthcare dilemma we are faced with today, especially how Obamacare works for some and not others. Also how the insurance companies tell the Drs. what they can and cannot do!:nah:

Well, what a heated discussion we could have about the state of affairs! What's important right now is for you to feel comfortable with your Dr./surgeon and to get back to a happy and healthy life! You're almost there!:friends:
 
Fortunately the maximum amount I will have to pay is somewhere between $4,000 and $7,000 (I'm just not sure how they figure the maximum when just my OS is out of network). Knowing I had two replacements coming up, I chose Blue Shield of CA's most expensive policy with no deductible and the lowest out of pocket amount. The $138,000 is such a ridiculous figure for three days in the hospital. Unfortunately those of us who do pay, end up being billed for those who too often don't pay as @SweetPea69 mentioned. My premium went up $230 a month this year. How many people can afford almost $900 a month for just one person? Not many and I know I'm very blessed in the fact that I'm able to pay this. It's a darn shame! Obamacare...please don't get this ranting Italian started on this issue!!!! :bignono:
 
:holysheep:I think my heart would skip a beat if I received a letter with that amount of money listed!! Yikes. And I can't believe you pay so much for health insurance per month!

I am lucky because my husband works for the local health system and the insurance I get is wonderful - about $200 a month for $250 annual deductible and zero coinsurance. My surgery cost was about $31,000 and I pay $250 of that.

Sorry hope I'm not making you jealous or anything . . . .:whistle:
 
Well it's an employer sponsored health plan (Anthem) and it doesn't have anything to do with the state. I guess when I wrote "local health system" made it sound state sponsored. He works at the city hospital and they just have really good benefits.
 
I just pray that whoever our next president is, overhauls our Obamacare. I like the idea of being able to purchase health care across state lines. We need more insurance companies to shop, which creates competition and lower premiums. Hey, I know, vote for Cynthia777 for president! ;-)
 
keepmovin said:
Granted, our taxes would probably go through the roof but in the end, less stress on everyone.
Click to expand...
My national insurance payments (the bit of tax that pay for the health service here) are about half of what Cynthia is paying for insurance. And that covers everything - in Scotland we don't even pay a prescription charge. I know I've been quite lucky in my waiting times but since diagnosis I cannot fault the care I've had.
 
Wow, girl! You went Platinum Plus for your hip replacement. :heehee: I'm glad you don't have to worry about paying any more than $7000 (still quite a chunk, but nothing near what that letter quoted!).
 
I never did see a hospital bill. Medicare paid it all. But I can tell you, my OS's charge was right at $9000 and he only got paid $1200.00 from Medicare. That's quite a big chunk of change his practice had to "eat", because of his agreement wit Medicare. Unfortunately, that's why bills are so exorbitant in the medical field now. Bureaucratic BS...and that BS doesn't stand for Bonesmart! But, I have to say, between Medicare and my supplemental insurance through AARP, I didn't have to shell out on penny. Age does come with certain benefits.

I am thrilled to hear you can now I move forward with you 2nd surgery @Cynthia777! Won't be long now, my friend, when you will be tiptoeing through the tulips.
 
I'm convinced the insurance companies will figure out how to jack up policy prices, no matter what insurance mandates are made by government. They are the only ones in the US who seem to be getting benefits from the Affordable Care Act. As for your policy, BCBS could have waited on sending that letter and figured out how to assess your bill, without trying to scare you. Geez! I've got BCBS through Anthem (state funded) and the initial bill is always the MSRP rate before it's reduced to negotiated rates. :rolleyes:
It's no wonder that people who can't afford insurance go bankrupt! (OK, Sheryl, step off the soapbox now...... ....)

"And now, back to your regularly scheduled program".
 
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