Insurance questions!!!
 

Has anyone ever got coverage by BCBS of ND for ADR surgeries out of country? I am looking into ADR in Breman, Germany with Dr. Ritter-Lang. I am curious what I can do to get things figured out with insurance before surgery. Any avenues you know of that I should start with.

Stay away from Ritter-Lang!!
 

Hi Brittney, I can't help with your insurance question, other than to say that I've read posts by many people on this forum that BCBS will usually not cover any type of surgery out of the country. However, there are a few who have been lucky exceptions. Don't expect them to pre-approve this under any circumstances. They won't. You've got to go in this with the expectation that you won't get anything from insurance.

I was going to get surgery by Dr. Ritter-Lang myself until I read posts on this thread: http://www.adrsupport.org/forums/f58...y-april-12014/

Just to summarize, it appears that a lot of bad things have happened with patients at Stenum. You only see testimonials of the patients who've done well. Honestly, 90% of his patients have gotten better because bad disc is taken out and new M6 artificial discs are put in. It's the other 10% that you need to be concerned about. It is my understanding that Dr Ritter-Lang and his team do 6 to 7 surgeries a day and run things like an assembly-line. Most other surgeons do 2 to 3 surgeries a day. I recommend you check out Dr. Clavel in Spain (not on the website with Dr Ritter-Lang though), Dr. Bierstedt in Germany, Mr. Dare in the U.K., and finally AIMIS Spine in Cyprus. It's good you're on here, because you can get the informed opinions of patients who have already undergone ADR.

Insurance is very important especially that medical expenses may seem costly and stressful due to rising expenses to be settled. This is also a big cry to the retirees, the costs of health care insurance both out-of-pocket and subsidized, are expected to keep going up. The extent to which these costs will go up will depend on a variety of factors, but expectations are that they will continue to go up. This year alone, out-of-pocket medical expenses for retired couples will go up to around $10,750 per year. Which is way too much to pay. So other people make way to pay those bills as early as possible. Some run after emergency cash to cut those payments.

I have BC/BS and had zero luck with them paying for my ADR. They did pay 100% for my distectomy that was done in the States. I ended up going to Cyprus with AIMIS and having my ADR surgery performed there by an American doctor. I do know that some companies, like AIMIS, have departments to help with the insurance issues.

I would not recommend survey with Dr. Ritter-Lang or going to Stenum hospital. Just my opinion, but there are better options out there. There are some great options mentioned on this board.

Feel free to drop me a PM if you want to know more about my surgical experience.

What Gene said.

Also, do not forget that once you spend more than 10% of your income on medical bills, the rest is tax deductible! Uncle Sam is paying for most of my surgery! We just have the outlay of cash up front. But a year from now we will get most of it back.

Regarding tax deduction
 

I need to make clear what I told Lillyth. Tax Deductible means a reduction of income that you are reporting to the IRS. It's not a tax credit where you get back dollar for dollar everything you spend. Think of mortgage interest. Every dollar you spend is deductible on Schedule A of your tax return. This reduces your taxable income. However, the actual dollars you get back from the government is based on your tax bracket (i.e. if you have $20,000 in mortgage interest and are in the 25% tax bracket, it's like you're getting back $5,000.00 from Uncle Sam). With respect to surgery overseas, you get to deduct medical expenses that are above 10% of your adjusted gross income. Here's an example. Say you and your husband have an AGI of $100,000 Let's say your surgery and travel costs run $40,000. This means $30,000 of this [10% of $100,000 is $10,000; $40,000 - $10,000 = $30,000] can be deducted on Schedule A and you will effectively get back $7,500 to $10,000 from Uncle Sam. My example is simplified. Most people never meet the 10% threshold unless they pay for major surgery overseas. However, once you meet this threshold, you can add every medical cost onto your Schedule A that you wouldn't bother to report normally (every doctor copay, every prescription drug copay, any mental health provider, acupuncturist, massage therapist, or medical expense not reimbursed by insurance, and any other elective surgery that is not considered cosmetic). This could make it so that your surgery is effectively covered 40% by Uncle Sam. Sorry if I may have mislead you Lillyth. However, you will most likely get a very large tax refund next year (just not dollar for dollar what you spend overseas).

What if we spend more or the same as my husband makes? Our CPA seemed to think we would get most of it back. Remember, my surgery is 80k. That and the plane tickets is my husband's salary.

Need to know your specific financial situation
 

Lillyth,

If you want to PM me, we can discuss your situation in greater detail. If the surgery works out to be more than your income, you will ultimately have taxable income of zero. Then everything that's been withheld from your husband's paycheck for Federal and State (most likely) will come back to you in the form of a refund when you file your 2013 taxes. All I'm saying is a tax deduction is not the same as a tax credit. A deduction reduces your taxable income and can bring you down to a lower tax bracket in many cases. A credit is a dollar for dollar reduction in your tax liability. Share this posting with your CPA and he'll clarify it.

Thanks Gene. Will do on both accounts.

German hospitals
 

I have been researching the other DR you commented on in Germany. It looks to me like there is alot of competition going on there. After your comment, I have been stressing if I made the right choice, but I haven't actually seen anything terrible that he has had for outcomes yet. I"m new to this support group though and am still getting used to the site. The other hospital has a lot of bad talk to Stenum hospital, and it seems really unprofessional. Now I don't know what to think!