My health insurance, for which I pay $395 per month, will not cover the foot surgery my doctor says I need: a toe joint replacement that is supposed to last 20 years and which will restore mobility and reduce pain.
Aetna won’t cover this; according to them the procedure is experimental, though it has been FDA approved. Aetna will, however, apparently approve two other procedures: fusing my toe to my foot so it would never bend again, or removing the joint so the toe sort of flops around. Yuck. But both options are supposed to eliminate pain.
I’m going for the surgery. Just how much does foot surgery cost, per foot? Despite numerous phone calls, calculating the exact total remains an unsolved challenge, because so many entities and individuals are involved: the Dr, the surgery center (which at least offers a 20% discount for patients paying out of pocket), the anesthesiologist, physical therapy (no clue yet what that’ll cost). Then there is the boot I’ll need to wear, plus pain medications and??? I don’t know what I’m missing.
Can you imagine a cost conscious consumer going into a department store and buying a dress without knowing precisely how much she’ll pay? How can you dispute a charge after the fact, if you’ve been given and then used a product or service?
Can any government fix problems like this and make it easier for patients to be informed?
Anyone who is happy with his or her insurance provider, feels comfortable with finding out accurate information, understands those Explanations of Benefits and has needed procedures need covered effiiciently, let me know!