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Tuesday, June 1, 2010

Medical Bills

Marc does the finances and pays the bills. When I started working, my paycheck was completely extra, so we had a few "projects" that we wanted to do, but also wanted to start building our savings. It was fairly easy to do about 6 months into me getting a paycheck, because our big projects were done. So we saved and in the last few months have slowed down a bit. He keeps saying, "I am trying to stay caught up on the medical bills." It started with my MRIs. That is when we finished my deductible for the year. Just $300, but then you tack on the visits to my OS here and there was a bit of change spent. I've also had a visit to Denver now in which I had to put down a $500 deposit for my surgery. A deposit is inevitable with this surgery, and anywhere from $500 to $1600, so mine was the low end. If you don't end up having to pay that, ie. your insurance actually pays for the surgery, you get the money back. However, our insurance is a 80/20 plan in most cases, or if we are lucky - and I'm not sure when that is, 90/10...I guess sometimes they pay 100%, but I can't figure out when that is, maybe this will be that time - if I'm lucky. The letter I received from my doctor states, "...this type of surgery has not been given a Procedure Code...we will use the 'unlisted procedure code' 29999 to describe this case. The procedure code 29999 will describe the femoral osteoplasty, acetabular rim trimming, labral repair, and associated procedures. The 29862 code will be reported for arthroscopy of the hip. Our fees for these services are follows: 29999 $9,500.00 and 29862 $2,221.00."
Twelve thousand in that part alone which doesn't include the hospital, anesthesiologist, braces, physical therapy, etc. I decided to call my insurance (Blue Cross/Blue Shield) this morning to see where things were at, and they were very friendly, but hadn't received any letters. They wanted my letters, and said they could send it for review with those, but I think I'll call the doctor and refer them to the lady I spoke with instead. After the insurance representative went on about the actual procedure, she added that the "Durable Medical Equipment" is usually covered once the surgery is, and even sometimes when the surgery isn't covered.

Remember the boots I have to sleep in?

I also have to sit in a CPM machine for several hours a day...

I would love to have a Game Ready Ice machine which continually passes very cold water through a cuff around my hip to keep swelling down. So if insurance doesn't cover this, I think I will pay for the rental.

I wanted to ask the insurance if we would hit our maximum out of pocket for this year, but after everything else, I figured it really didn't matter. I will be happy if they pay their portion of all of this. I am also curious to hear if anyone has had a similar experience, and what the outcome was for you.

I finally found a Calcium supplement that doesn't make me sick. I will be taking that every day. Vacation begins next week and I have hopes of being able to enjoy it and still be reasonable with doctor's orders. Just three more weeks until my MRI.


  1. Wow, the lady in the CPM machine is a hottie! Can't wait to see what Marc thinks of you in that awesome machine :-) (giggling)

  2. Hi Sara - I'm a fellow fai surgery person - about 11 weeks post-op for the first hip. I am in CA but I have blue shield too. They did cover the surgery - but i did end up hitting my out of pocket maximum - that 20% copay adds up when you have hospital fees. I had a cpm machine and a game ready for about 2 weeks - i don't think either was covered and they ended up costing around $600 total. The gameready maching was really great - and i think totally worth it. Best of luck to you and I'll be following your progress :)