Freshfig,

All I can say to your Medicare question is to keep asking questions and get the names of the people who answer them and try to record your phone calls with them to document their responses. You need to inform them that you are recording the call to keep it legal for your protection. If they won't agree to the recording then just try to document response in writing as they give it. You are now in a negotiation to force two entities to live up to their contractual agreement with you and each other. You are close to getting it done it is just a matter of the bottom line cost for everyone.

First find out if your Dr. and hospital has a contract with Medicare and accepts other Medicare patients. Some do, some don't. If they do have a contract with Medicare ask them why they won't accept Medicare's figures and then contact a Medicare lawyer as to your legal rights to force the hospital to live up to their contract with Medicare. I would guess that if they have a contract with Medicare then they have one with you by default.

If your Dr. and hospital don't have a contract with Medicare ask Medicare why the reimbursement is so low for this surgery? Ask them how they determine what their reimbursements rates will be for any surgery and where in your Medicare contract does it spell this out in writing. Ask them what hospital and qualified Dr. do they have available that will accept their figures to do this surgery. Try to back them into a corner where their answers will trip them up.

At the same time you are working on Medicare ask your Dr. and hospital how far a part the Medicare reimbursement rate is from what they will do it for. Ask them if you can make up the difference. Once you got the figure then ask them what kind of payment plan will they accept to help you out with this. If you can get the hospital and Dr. to agree to do it with out you paying all the difference up front then go for it and worry about how you will pay for it later. Unpaid medical bills will not impact your credit as other bad debts do, and as long as you can make some kind of regular payment to the hospital they will wait for it.

Your goal here is to get fixed so you can get back to living a normal and productive life. I must also say that only you and your Dr. know your medical situation. I assume that you both agree that ADR is the best course of action for getting you better. There are risks to this surgery and you have to be prepared to deal with a less them optimum outcome. Your pain and quality of life should be so bad that anything will be better then what you are living with today.

Good luck with it. You are close and persistence does pay off

Pat