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  • #16
    Re: Health Insurance

    There is another thing you have to figure into the equation and that is the doctors' bills, including the anesthesiologist, which are separate from the hospital. Make sure ALL doctors will accept whatever insurance you have as full and final payment. I am still getting bills from one doctor two years ago that came into the room for 5 minutes and was paid by my insurance company.

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    • #17
      Re: Health Insurance

      Sorry for the confusion - that amount was for my myectomy in 08 (2 days testing, surgery, hospital). My visits since then, are for 2 days testing and I think everything (hotel incl) for those follow-up visits are around 1600. That statement is just a marketing statement - essentially, that they put you and your health above their profit goals.
      Marc
      Diagnosed @ 48
      Saw Dr. Michael Debakey @ age 5 - "He's fine, just a little noisy"
      Father to 3 boys 22, 25, 29 (all currently clear - pending genetics)
      AICD - Valentines Day '08, Spark Plug replaced 11/14
      After much research, I had a Myectomy @ Mayo for my 50th Birthday '08
      Quietly going insane . . .

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      • #18
        Re: Health Insurance

        My invoice(s) from Cleveland clinic were about the most clear and cogent financial statements I have ever seen. They included everything except the taxi ride to the door, and I mean anesthesia and all sub specialties including pharmacy. We received no invoices from anyone else. The full retail cost for three days of pre-op tests, myectomy and five days of care post-op came to about $139,000. The adjusted amount that Blue Cross paid was about $120,000 something and change. My PPO plan had a 20% copay but a cap of $10,500 out of pocket, so the damage was limited to that. We were lucky that I could liquidate some retirement assets and we know that not everybody can do that, so we are thankful that the only downside is working another year or two. Ironically it is the myectomy that will allow me to do so.

        I think that fixing the affordable care issues has a lot to due with local providers re-aligning themselves with new regional insurers. I dropped blue cross for Humana at a great savings for essentially the same PPO plan, but Humana has not been a big player in the region. My own internist did not take Humana so I had to wait two months for his practice to scramble to get in their network before I could get a physical. Many local private practices are selling out to the local regional hospital system, giving up some equity in exchange for losing the burden of navigating the insurance and financial matters and the exposure that creates. So soon I imagine that my local medical invoices will look like those from Cleveland - all services under one system. Then it's a matter of public debate as to whether such centralization is good for the patient.
        Angus Campbell
        Golden Isles Region, Southeast Georgia, USA

        Dx'd HOCM at St Luke's Roosevelt, New York City, 2005
        Myectomy Jan 9th 2014 at Cleveland Clinic
        Drs Lever and Smedira

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        • #19
          Re: Health Insurance

          Angus -

          Due to the influx of patients from around the world Cleveland and Mayo may require all their attendings to join and accept every health insurer there is, I don't know. What I do know is that is not the case with every hospital including SLR nor do I think that will ever be the norm until and unless the US goes with socialized medicine.

          I know several doctors including a family member, surgeon, who do not accept any insurance.

          Not debating your experience with Cleveland, nor will I if anyone states the same for Mayo, as I was never a patient at either and have no first-hand knowledge. The only thing I was trying to do was alert people to the possibility and to research beforehand.

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          • #20
            Re: Health Insurance

            Yes you are right of course. We asked tons of questions before going to Cleveland and tons more before jumping ship from blue cross. I was noting what might be a future trend. Thanks for the amplification.
            Angus Campbell
            Golden Isles Region, Southeast Georgia, USA

            Dx'd HOCM at St Luke's Roosevelt, New York City, 2005
            Myectomy Jan 9th 2014 at Cleveland Clinic
            Drs Lever and Smedira

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            • #21
              Re: Health Insurance

              My two cents: I am covered under my (nurse) wife's policy at a hospital in colorado. It's called EBMS, in association with Cofinity. We had a tough time at the beginning explaining the need for me to go "out of network" for myectomy at Mayo. Mostly they had me under the 'wrong' heading or coding. Once I did a lengthy explanation, they said okey-dokey....clearly this procedure was not available 'in-network.' (Big hospital in denver has done plenty of ablations, and some myectomies, but I wanted the option of choosing Mayo, and the HCM -specific department in Rochester....) Definately get approvals in writing. Mayo was excellent at guiding us and keeping us informed. Keep on top of the communications. Glad I got this done when I did, under insurance; at one point I considered waiting till I was covered by MediCare.......whew! Not all paperwork in yet, but I think I will be near $150,000, with a fair amount of prelim work (angiogram, echo, etcet) in-network and at my local hospital.
              Rich

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