Looking for advice regarding tkr & insurance

[jessymi]

Hi I joined last fall, I was having a problem with the first doctor I saw and I took everyone's advice and saw a new doctor. He worked out great! I was able to get some questions answered and he told me what options I had. He told me that I was a candidate for tkr but if I wanted to try other things first we could. I wanted to try the cortizone injections since I have always had good response with it in the past. The first one was great, I actually got to go Christmas shopping for the first time in years. The 2nd one lasted even longer, and while the joint itself had no pain, as time went one I started to feel stress in my shins when walking. Has anyone experienced that? Anyway I still am not able to do things come the end of the day, so I did schedule a tkr for my right knee. Now the problem is my husband just got let go from GM and we will only have insurance for six months, I have never been thru this so I don't know what options I have afterward. My husband wants me to still have the tkr because he said we don't know what the future will bring (we are both only 52 & to many years from retirement). He's afraid that I might not get to have the surgery for many years. I am worried about complications after surgery. We will only have 4 months of GM coverage, and I would guess we would be able to get some kind of coverage for a little while afterwards. Any suggestions or comments?

 

[Surfsister]

One of the reasons why I had my surgery when I did (April 20) was because we, too, probably won't have medical insurance for much longer. My husband was laid off from his job in October. He had cancer at the time of the layoff so his company allowed him to continue his medical coverage (under COBRA, which allows employees to continue purchasing medical coverage even though they've lost their jobs) at a reduced rate. Don't worry, his cancer was caught in time and he's now cancer-free. Anyway, in the meantime, I went to the orthopedist for the first time in six years and learned that my knee had finally gotten to the point where I'd become a candidate for knee replacement.

I've found that many people wait and think about whether to do the surgery and when. With the pain I was having and the look of my x-ray, it was clear that I was a candidate for an immediate knee replacement. We currently pay a reduced rate of $300 per month to insure the three of us. As of June, our monthly COBRA payment will go up to $1300. We cannot afford that. With all of that in mind, I had the surgery as soon as possible (about a month after I saw this doctor).

I don't know what the future holds for us in terms of jobs and insurance. At least now, I won't be in pain and won't have to worry about needing the surgery in the future (when we probably won't have insurance).

Do look into COBRA payments. The federal government mandates that employers allow former employees to purchase medical insurance through the company for 18 months. The COBRA payments are often pretty high. We were just lucky his company allowed us to pay at a reduced rate for a time. I think the federal government is also trying to help those of us dealing with COBRA and is encouraging people to apply for some program that helps with the COBRA payments. It's all a bit unclear to me. I'm the one trying to recover from the surgery.

Think about what you need to do for you. When considering a knee replacement, you have to put yourself first when making your decision. This is all about your health, your well-being. Think about what will work best for your happiness. For me, it was getting the knee replaced so that I could get on with my life.

 

[Texas]

Yes thats what I did Minhusband lost his job ib Dec so I got the TKR. And now I am paying Cobra for a few mths thats probably all I can handle. But The biggest parts will be out of the way. If the Dr. thinks you need one, and you want to have it and hubby says yes?? The rest will work out. But take care of you first....Kim

 

[Simon]

Dont wait, have the TKR as soon as possible so that you have the maximum time of coverage for surgery and rehab. Also, once you have a TKR you will have trouble getting insurance (unless things are reformed) and being miserable for years is not fun. The biggest cost is the surgery and the PT so get that out of the way. If something happens the doctor can work something out.

I have had the shin pain you describe and it seems to be from stress ligaments/tendons as my walking changed to adjust to the nonfunctioning knees.

If the schedule surgery is not very soon, ask the doctor to reschedule and tell him about the insurance problem so he will do it

Simon

 

[Judles]

I echo Simon,Jesse......Especially since time flies and you want to make sure COBRA doesn't run out when you need it the most! Good luck! . And the sooner you schedule, the faster you'll start feeling much needed relief!!

 

[Gretchendz]

Under the President's Stimulus plan, depending on when your husband lost benefits, you may be eligible for 65% of the COBRA premiums to be paid for you:

broken link removed: https://www.dol.gov/ebsa/cobra.html

But, regardless, do the surgery ASAP while you have health insurance! COBRA is typically available for 18 months.

 

[Jamie]

I'm on the same side as everyone else. Go for the high dollar item (the surgery) as soon as possible. Talk to your surgeon so he understands why you need it soon. Then start researching options for some type of coverage afterwards. There are options out there, but you have to look hard sometimes to find them. If you are unable to find insurance and you have a situation that needs medical attention, you can go to a teaching hospital (hopefully you live near one) and/or discuss the situation with your doctor. Many times doctors and hospitals will make allowances for people who are without insurance. The important thing is to get the surgery done as soon as possible so you can start on the road to recovery with good insurance benefits on your side.

Great link, Gretchendz. Thanks for posting it!!!