Re: Will Any HMOs Cover Resurfacing???

[Guest guest]

I have PPO/EPO Blue Cross Blue Shield. They just denied my

surgery. I am trying desperately to find some insurance information

too. I have osteo arth left hip. Using a cane to walk. I can't

hold out much longer. My surgery was August 11 now .... none.

> I talked to one of the resurfacing doctor's office recently and

they

> seemed to think if you have an HMO, they will not cover hip

> resurfacing. Has anyone had any luck with an HMO, or do I have to

> wait until March 1st 2005 when I can switch to a PPO?? By then,

I'm

> worried whether or not my ball on my femur will still be in good

> enough shape to qualify for resurfacing. So far, I'm holding my

own

> and the last x-ray, a few months back showed little to no

cartilage,

> but no wear on the ball.

>

> Any ideas??

>

> Limping in Michigan,

>

>

[Guest guest]

I'm very discouraged about getting my HMO to cover resurfacing. It

can't hurt to try, so I think I'll go through the motion to see what

happens. The most encouraging thing I've seen so far with insurance

coverage is the info Aetna has on their web site about hip

resurfacing. They talk highly of the procedure and sound like they

will cover the procedure without issue. I hopt this is a new trend,

since the process makes so much more sense than the traditional THR.

How are the rest of these surface hippies getting insurance

coverage??? I don't get it.

> > I talked to one of the resurfacing doctor's office recently and

> they

> > seemed to think if you have an HMO, they will not cover hip

> > resurfacing. Has anyone had any luck with an HMO, or do I have

to

> > wait until March 1st 2005 when I can switch to a PPO?? By then,

> I'm

> > worried whether or not my ball on my femur will still be in good

> > enough shape to qualify for resurfacing. So far, I'm holding my

> own

> > and the last x-ray, a few months back showed little to no

> cartilage,

> > but no wear on the ball.

> >

> > Any ideas??

> >

> > Limping in Michigan,

> >

> >

[Guest guest]

I'm very discouraged about getting my HMO to cover resurfacing. It

can't hurt to try, so I think I'll go through the motion to see what

happens. The most encouraging thing I've seen so far with insurance

coverage is the info Aetna has on their web site about hip

resurfacing. They talk highly of the procedure and sound like they

will cover the procedure without issue. I hopt this is a new trend,

since the process makes so much more sense than the traditional THR.

How are the rest of these surface hippies getting insurance

coverage??? I don't get it.

> > I talked to one of the resurfacing doctor's office recently and

> they

> > seemed to think if you have an HMO, they will not cover hip

> > resurfacing. Has anyone had any luck with an HMO, or do I have

to

> > wait until March 1st 2005 when I can switch to a PPO?? By then,

> I'm

> > worried whether or not my ball on my femur will still be in good

> > enough shape to qualify for resurfacing. So far, I'm holding my

> own

> > and the last x-ray, a few months back showed little to no

> cartilage,

> > but no wear on the ball.

> >

> > Any ideas??

> >

> > Limping in Michigan,

> >

> >

[Guest guest]

Hi ,

My resurf seems to have been almost fully covered by my HMO

(AETNA).

Chris

> I talked to one of the resurfacing doctor's office recently and

they

> seemed to think if you have an HMO, they will not cover hip

> resurfacing. Has anyone had any luck with an HMO, or do I have to

> wait until March 1st 2005 when I can switch to a PPO?? By then,

I'm

> worried whether or not my ball on my femur will still be in good

> enough shape to qualify for resurfacing. So far, I'm holding my

own

> and the last x-ray, a few months back showed little to no

cartilage,

> but no wear on the ball.

>

> Any ideas??

>

> Limping in Michigan,

>

>

[Guest guest]

That's great Chris. I have Priority Health, an HMO based out of West

Michigan. I searched their web site, but didn't find any reference

to hip resurfacing. Can't say for sure they won't cover it. So I

better get the process started and see where it goes. Cross your

fingers. I wouldn't know how to act if I could walk as fast as

everyone else does. I have to remind my wife every so often when

she's gotten about 15-20 feet out in front of me, that she'll need to

slow down if she wants me to keep up with her. Kind of frustrating,

don't you think? We've got a trip scheduled to Dominican Republic

next February. Sure would be nice to walk the beaches without a limp.

Thanks for letting me know there is at least one HMO covering this

procedure.

> > I talked to one of the resurfacing doctor's office recently and

> they

> > seemed to think if you have an HMO, they will not cover hip

> > resurfacing. Has anyone had any luck with an HMO, or do I have

to

> > wait until March 1st 2005 when I can switch to a PPO?? By then,

> I'm

> > worried whether or not my ball on my femur will still be in good

> > enough shape to qualify for resurfacing. So far, I'm holding my

> own

> > and the last x-ray, a few months back showed little to no

> cartilage,

> > but no wear on the ball.

> >

> > Any ideas??

> >

> > Limping in Michigan,

> >

> >

[Guest guest]

Re wear on the ball - I had no cartilage for 18 months, plus was

diagnosed with osteoporosis, and Dr.De Smet was still able to do a

resurfacing

Saunders

> > > I talked to one of the resurfacing doctor's office recently

and

> > they

> > > seemed to think if you have an HMO, they will not cover hip

> > > resurfacing. Has anyone had any luck with an HMO, or do I

have

> to

> > > wait until March 1st 2005 when I can switch to a PPO?? By

then,

> > I'm

> > > worried whether or not my ball on my femur will still be in

good

> > > enough shape to qualify for resurfacing. So far, I'm holding

my

> > own

> > > and the last x-ray, a few months back showed little to no

> > cartilage,

> > > but no wear on the ball.

> > >

> > > Any ideas??

> > >

> > > Limping in Michigan,

> > >

> > >

[Guest guest]

Re wear on the ball - I had no cartilage for 18 months, plus was

diagnosed with osteoporosis, and Dr.De Smet was still able to do a

resurfacing

Saunders

> > > I talked to one of the resurfacing doctor's office recently

and

> > they

> > > seemed to think if you have an HMO, they will not cover hip

> > > resurfacing. Has anyone had any luck with an HMO, or do I

have

> to

> > > wait until March 1st 2005 when I can switch to a PPO?? By

then,

> > I'm

> > > worried whether or not my ball on my femur will still be in

good

> > > enough shape to qualify for resurfacing. So far, I'm holding

my

> > own

> > > and the last x-ray, a few months back showed little to no

> > cartilage,

> > > but no wear on the ball.

> > >

> > > Any ideas??

> > >

> > > Limping in Michigan,

> > >

> > >

[Guest guest]

,

The insurance issue is best left to the surgeon's office, at least

until they say no. At that point, the appeal is up to you.

Fred

Dr. Gross, C2K 1/21/04

> > > I talked to one of the resurfacing doctor's office recently

and

> > they

> > > seemed to think if you have an HMO, they will not cover hip

> > > resurfacing. Has anyone had any luck with an HMO, or do I

have

> to

> > > wait until March 1st 2005 when I can switch to a PPO?? By

then,

> > I'm

> > > worried whether or not my ball on my femur will still be in

good

> > > enough shape to qualify for resurfacing. So far, I'm holding

my

> > own

> > > and the last x-ray, a few months back showed little to no

> > cartilage,

> > > but no wear on the ball.

> > >

> > > Any ideas??

> > >

> > > Limping in Michigan,

> > >

> > >

[Guest guest]

Thanks for the feedback Fred. I guess I'm finally coming around to

that idea. If I don't go try, I won't know for sure, so today I

picked up my x-rays on the way home & FedEx'd them to Dr. Gross in

S.C. We'll see where it goes.

> > > > I talked to one of the resurfacing doctor's office recently

> and

> > > they

> > > > seemed to think if you have an HMO, they will not cover hip

> > > > resurfacing. Has anyone had any luck with an HMO, or do I

> have

> > to

> > > > wait until March 1st 2005 when I can switch to a PPO?? By

> then,

> > > I'm

> > > > worried whether or not my ball on my femur will still be in

> good

> > > > enough shape to qualify for resurfacing. So far, I'm holding

> my

> > > own

> > > > and the last x-ray, a few months back showed little to no

> > > cartilage,

> > > > but no wear on the ball.

> > > >

> > > > Any ideas??

> > > >

> > > > Limping in Michigan,

> > > >

> > > >

[Guest guest]

Thanks Chris.

That gives me some hope. I sent my x-rays off to Dr. Gross on the

way home from work today, so we'll see where it goes. I finally

realized, nothing was going to happen until I made a move. I hope my

HMO has good moral values which makes them understand hip resurfacing

is absolutely the best choice for their clients. Hopefully, it won't

take too long to find out.

I'll post back when I hear more.

> > > > I talked to one of the resurfacing doctor's office recently

> and

> > > they

> > > > seemed to think if you have an HMO, they will not cover hip

> > > > resurfacing. Has anyone had any luck with an HMO, or do I

> have

> > to

> > > > wait until March 1st 2005 when I can switch to a PPO?? By

> then,

> > > I'm

> > > > worried whether or not my ball on my femur will still be in

> good

> > > > enough shape to qualify for resurfacing. So far, I'm holding

> my

> > > own

> > > > and the last x-ray, a few months back showed little to no

> > > cartilage,

> > > > but no wear on the ball.

> > > >

> > > > Any ideas??

> > > >

> > > > Limping in Michigan,

> > > >

> > > >

[Guest guest]

Thanks Chris.

That gives me some hope. I sent my x-rays off to Dr. Gross on the

way home from work today, so we'll see where it goes. I finally

realized, nothing was going to happen until I made a move. I hope my

HMO has good moral values which makes them understand hip resurfacing

is absolutely the best choice for their clients. Hopefully, it won't

take too long to find out.

I'll post back when I hear more.

> > > > I talked to one of the resurfacing doctor's office recently

> and

> > > they

> > > > seemed to think if you have an HMO, they will not cover hip

> > > > resurfacing. Has anyone had any luck with an HMO, or do I

> have

> > to

> > > > wait until March 1st 2005 when I can switch to a PPO?? By

> then,

> > > I'm

> > > > worried whether or not my ball on my femur will still be in

> good

> > > > enough shape to qualify for resurfacing. So far, I'm holding

> my

> > > own

> > > > and the last x-ray, a few months back showed little to no

> > > cartilage,

> > > > but no wear on the ball.

> > > >

> > > > Any ideas??

> > > >

> > > > Limping in Michigan,

> > > >

> > > >