If you can cover the cash outlay for 3-6 months and you won't loose your house if they don't pay then you can try this. Ins. has some strange rules but they may work in your favor. Read your policy rules on how many planned days you can stay in the hospital before you need their pre-cert. My policy said 3 or more scheduled days in the hospital required pre-cert. Most ADR patients can be out in 2 days. Don't plan on driving home then, just get a hotel room near the hospital and stay till your first follow up.


Tell the hospital you want a cash package price for your planned 2 day stay since you are having to pay for it all yourself. Don't let on you are going to submit for reimbursment after surgery. You should be able to get a single level done for $35-$45,000. If the come back with $60-80,000 tell them you have been looking into going to Germany for under $35,000. If they are having problems getting insurance to pay or pre-cert others they will jump at the chance for a cash customer. Your Dr. office may also not know how to handle cash customers. If they don't, ask if they have an international patients dept. They will know how to get you a package deal.

After surgery request an itemized list of all your charges with ins. codes and then submit this to you ins. co. You can try to get the hospital to submit for you, but they sometimes won't do it for package deals. I don't think your ins. can or will deny an FDA approved procedure. If they do try to deny it then call your states insurance commisioner and tell them you have followed all your ins. co. rules for this FDA approved procedure and they won't reimburse you.


Good Luck and work the system to your advantage.

Pat