I feel like nothing has really happened since my last post, but actually, I do have more information since then - especially about the insurance stuff.
I have generally pretty good insurance coverage - if I were having this surgery with a local in-network provider, I'd probably have to pay around $1,000 out-of-pocket, depending on how many days I spent in the hospital. When I consider that the total bill is probably minimum $50,000 in my geographic region, I consider it good coverage.
One thing my insurance provider has been stellar at is customer service. I can always reach a customer service agent, and they have a consistently helpful attitude, which for some reason surprises me. When the customer service agent was in over her head with some of my questions, she had a nurse case manager contact me. The nurse case manager (who was a hoot on the phone) gave me her full name and direct line so that I could contact her with other questions as they come up.
What I've learned is that none of the US surgeons I would be willing to travel to are part of the out-of-Oregon network. This means I would be responsible for 20% of the allowable amount. This also means that if the actual charges are more than the allowable amount, I would be responsible for the entire difference. Since the allowable amount is a regional average, I expect that the actual charges in NYC would indeed be higher than the Oregon allowable amount.
I've also learned that since I do not have 'normal' bone density, my surgery would not be pre-authorized. So I expect that means, if I want them to cover it, I have go through some sort of appeal process where I try and wrangle the insurance company. That does not sound fun.
Lemme 'splain. No. There is too much. Lemme sum up: I could spend time and effort convincing an insurance company to cover a portion of the surgery, and still spend more out-of-pocket dollars for a (still excellent but) less experienced surgeon. Or I could try to get on the list with Dr. Vijay Bose in Chennai.
I've officially requested him to resurface my hip, and it's all I can do to keep from checking my email every 20 minutes. Though at some point it becomes moot, as Chennai is 12 1/2 (odd, I know) hours ahead of Oregon. There's no point in checking for another eight hours, at least!
