ADR COST?

I'm baffled as to how the health insurance works in the U.S. Here in Australia the surgery is covered almost completely by insurance if you have it. Also, the ins.co don't decide who can and can't have surgery as I"m reading a lot of from the U.S. patients.
MY out of pocket quote is just under $5,000 from my surgeon incl. anaesthetist and assistant surgeon. I also have a $600.private hospital excess which I'll have to pay myself. Well worth paying my monthly premiums I'd say!

[hucky]

Yes Kathy,

I've noticed the odd way private health insurance operates in the US too. I was quoted $4,000 out of pocket by my NS 18 months ago. My excess is $200. It's the NS who decides who can and can't have surgery and that would be because of the suitability of the patient and no other reason.

Kathy, do you know if Medicare does it and if so, how long is the waiting list?

Hucky

Sorry Hucky, I've no idea if medicare would cover ADR. You would wait years to get into a public hospital unless you went in through A and E, and then you would get any surgeon who was rostered or worse their assistant! As I'm not a very healthy person I wouldn't be without my health ins for anything.

[rob_zzz]

Originally posted by bob:
[qb] Hi Kathy

My 2 level cervical ADR cost around $60,000 australian all up.

Bob [/qb]

Bob just curious - was that 'out of pocket' expense or was it partially refunded by health insurance and/or medicare?

thanks,
Rob

[Ms Em]

My husband had 2 level ADR and fusion (to correct the scoliosis and kiposis) at Stenum on March 23, 2006. Cost for surgery, clinic, 1 week stay at hotel in Bremen was 35,000 Euro's. Also another $2,500 for my hotel, food, etc for 4 1/2 weeks.
MsEm

[Ms Em]

Maybe this will answer the question about "strange" coverage in the USA.
1. The health insurance companies are private and are in the business of making money. The less the insurance company pays out the more profit the company makes.
2. I think there is a lot of politics in the FDA appproval for medicines vs/and medical devices. If FDA does not approve, insurance company has an easy way to say, "We will not pay."
MsEm

[chasswen]

single level adr with dr b quoted at 24,051 euros
at the monet 31,089 us dollars
im still trying to get my heart to start again
chuck

[Cat]

Hey Kathy,
I just read your reply to Maria. Did I understand you correctly? You are a work comp patient and they are going to approve you to go to Germany for your surgery? If so, are they covering all costs? Did you have to have a lawyer fight for you? Which ADR are you getting? Who is your Dr.? Do you have a date scheduled? Does he/she had a lot of surgeries of this type under his/her belt? Sorry for all of the questions, but I am crazy with pain, need a fusion, but would rather check into ADR. Please respond at your earliest convience. Thanks so much

[nduetime]

Originally posted by cathy:
I'm baffled as to how the health insurance works in the U.S. Here in Australia the surgery is covered almost completely by insurance if you have it. Also, the ins.co don't decide who can and can't have surgery as I"m reading a lot of from the U.S. patients.
MY out of pocket quote is just under $5,000 from my surgeon incl. anaesthetist and assistant surgeon. I also have a $600.private hospital excess which I'll have to pay myself. Well worth paying my monthly premiums I'd say!

i'm think the cheapest way for an american to have the procedure done is to move to australia, become a citizen and purchase insurance there. it's rediculious the anout of hoops us americans have to jump through in hopes that we can get the procedure covered. in fact...i'm not even sure why anyone would get insurance anymore-b.

[hucky]

So far, our premiums are a lot lower too. We're in top cover for hospital and extras and we pay $204 per month. We have a $200 excess if we are admitted to hospital and if we go with a surgeon and hospital that is aligned with the health fund, no out of pocket expenses. Everything is covered - surgeon, anaethetist, theatre, recovery, medication etc.

We're squawking at paying $204.00 !!

If I wasn't a third party insurance patient and I was just a normal person needing surgery and decided to go with ADR here, because the TGA doesn't approve of cervical ADR yet, I would have to pay out of pocket approx $4,000. If I was a lumbar case - everything is covered.

Because I'm a MVA third party insurance patient, I would have to pay out of my settlement which is approx $30,000 - $40,000. Still cheaper than over there !!

It seems to me that either our neurosurgeons/orthopedic surgeons are grossly underpaid or yours are grossly overpaid. It's baffling. Europe seems more in line with us as far as costs.

Hucky