HOW TO COP INSURANCE

[Anne]

Hello there everyone.  After months - years actually - of work researching, eliminating options, taking films and bone scans, losing weight, talking via e-mail to De Smet, I've made the decision to have a BHR.

PROBLEM:  No insurance.  How do I cop insurance fast and guarantee coverage?  I am disabled with Medi-i-Cal and Medicare in California, and, there's not a snowball's chance in &^$$ they'll pay for it.  Any help you all can lend will be a great help to me.  I'm in the "severe arthritis" stage, and Koen De Smet books 10-16 weeks out...

I only want De Smet.

Anne

[Pat Walter]

Getting insurance when you have hip problems is basically impossible.  I tried and could not get any.  Once you have hip, knee or joint problems - you can't get insurance.  THat's our great American Health Care System.

I don't know if you could possibly get your coverage to pay for a hip resurfacing.  You might check my California doctors list to see who might take your insurance. 

Dr. De Smet is the best - but it would cost more than $18,000 to go there.  It cost us that much 2 years ago and the dollar keeps losing value against the Euro.

Dr. Bose of India is also a great surgeon.  You can do him for $10,000 to $12,000   

I am sorry I don't have any solution to getting new insurance.  If you find one, please let me know because both my husband and I don't have any.  His heart attack and triple bypass cost $104,000    The hospital wrote it off to chairty for us.  We were very lucky.

Good Luck.

Pat

[Elaine Y.]

Hi,

The fact that you have a pre-existing condition may necessitate a waiting period before an insurance company will cover you. If there is no break in coverage from one insurance company to another, then there is a good possibility that the waiting period will be waived. I changed insurance companies in September when my husband switched jobs. I had to prove, with the help of the former insurance company, that I had coverage throughout my diagnosed hip condition. The old insurance company was in contact with the new insurance company, and it was a matter of days when they waived the "pre-existing condition clause" for me.

It worked out very good for me in that I chose a PPO instead of an HMO, which meant I could pick the surgeon I wanted to go to. It is a bit more expensive, but well worth it to be able to chose your physician and no need for a referral from your primary care physician. I went to my first orthopedic surgeon to discuss the BHR in November, but was not satisfied with that OS and chose another, Dr. Eugene Lopez, and saw him in December. I had my surgery in January 2008.

But, if you are currently uninsured right now to get immediate coverage from an insurance company may cost you a lot or at least you may have to wait anywhere from 1 to 2 years before they will cover anything to do with your pre-existing condition of your hip. If you are disabled and on any kind of social security or Medicare, I would do as much research as you can to get them to pay for it. I hear it can be done, but you have to be very diligent and persistent in your endeavor.

Good Luck. I hope you will be able to get your hip resurfaced if not here in the US, then overseas.

Elaine Y.
RBHR -- 1/22/08 -- Dr. Eugene Lopez