Preparing for surgery in an insurance-chaotic world

[Guest guest]

Rose touched on one thing I'd like to follow up on: rehab.

Following my last hip replacement, I was sent to a GREAT rehab unit. They

were fantastic, did not consider me a " problem " because I didn't fit the

textbooks, had me up and moving in no time, even found me a bed that would lower

enough for me to practice getting up and down myself (which of course I would

have to do at home). I can't say enough good about them. My total recovery was

7 weeks, much shorter than following other surgeries.

HOWEVER - my insurance did not want to cover it, because their guidelines said

I should have gone to a nursing home. I screamed and screamed (okay, I wrote a

lot of letters) and eventually they covered it, but the lesson is: check it out

ahead of time. Following surgery such as hip replacement, you will need rehab,

and you may need home health visits. Find out what your insurance covers, and

find out if it's adequate for your needs, and if it's not: SCREAM LIKE HELL.

I also discovered (after the fact) that my insurance did not consider my home

health provider to be a " preferred provider, " which left me with a $1300 bill.

Thanks a lot! I negotiated it with the provider, who agreed that they and I had

both been told they were covered, and I " only " had to pay $650. Again, the

lesson is: check it out ahead of time and try to get it in writing.

I think a ploy some insurance carriers are using is to delay approving things,

so that by the time they decide, you've already had to do something. Get it

early and get it in writing!

Alyce :-)