Doctor approved me for resurfacing - Kaiser considers this elective surgery

[Cutter3]

So I had my consultation with Dr. Klug, and it went well.    He said I was an appropriate candidate for the resurfacing, and I've asked to be put on the schedule for a resurfacing.

I sent him an email after our meeting, asking if the surgery was considered elective or not, and he confirmed that it was indeed considered elective.   Has anyone here dealt with Kaiser and a hip resurfacing?     Will Kaiser cover this as they would anything else?  Do I need to jump through hoops?



Chris

(whoops  - wrong forum.   this should be in the "insurance questions" subforum...)

[Cutter3]

spoke to member services, and they told me that elective surgery is not covered by my insurance.   Does anyone know if there's an appeal process for this, or if a doctor can deem this medically necessary?   I really don't want to continue to be inactive, pop pills, be in pain, and all that good stuff...

Now I'm depressed.   No way can I cover this out of pocket...

[Cutter3]

Nevermind - it's a case of wording on the Dr's part - Dr Klug has deemed this medically necessary.    Please excuse the above posts...

(And Dr. Klug is AWESOME.   He was in surgery when I was supposed to have my original consult, so he made late-night hours available for me to talk to him.   Very comfortable with him, and he is well aware and appreciative of this website - he's also now over 400 resurfacings...)

[B.I.L.L.]

Mine was done through Kaiser, but not Dr Klug.
I sent him my x-rays when I was having some problems early on and he called me and spent probably 1/2 hour or longer going over my options and the pros and cons of re-positioning my steep cup. Wish I would have known about him before I went with Kaiser in Fontana, I would have driven to Roseville in a second. Class act IMO and was very helpfull and understanding. I think he is easily your best choice in the Kaiser system. Good luck !!  8)

[Lopsided]

Elective! Of course everyone elects to have the best treatment. Sound like another way insurance companies weedle their way out of paying.

[trumpetman]

With Kaiser you have to call member services and ask for a quote on what it is going to cost you out of pocket.  They have so many different policies now. 

I have a high deductible with a yearly max. out of pocket of $3000. This gives me lower monthly for my son and I, since we are otherwise never sick.

I have a co-pay of $500/day for in-patient hospital care.  The will basically max out my out of pocket for the year, so I then pay nothing else.

Dr. Barber in Oakland Kaiser also has done 300+ BHRs and is very nice.

stephen