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PeggyMPPeggyM Posts: 129
edited 06/11/2012 - 8:44 AM in Health Insurance Issues
Hello all you helpful people!

My son is looking at L5 - S1 Fusion surgery. He is having a PLIF & ALIF minimally invasive procedure in early July and he has been on SSDI for 2 years with Medicare. The amount he gets from SSDI is under $1000 a month and hardly covers his rent and utilities. He is a single father with 2 young boys and struggles from month to month.

My question is: does anyone know how much this surgery will cost? He is expected to pay 20% of it!! He is also looking at future surgery as he has neck issues also.

a very worried mom!


  • I would think your son also gets checks for his sons (your grandsons). My daughter is on SSDI and gets a check for each of her sons (3 yrs old and 6 yrs old). She has Multiple Sclerosis.

    I'm on SSDI myself. My Medicare kicks in this coming November. I couldn't say how he would handle the 20 percent he has to pay. Is there any chance he could look into getting a supplemental Insurance Plan? I forget the exact category these are but they are offered to Medicare Beneficiaries to help pay what Medicare does not pay.

    I am very fortunate I have medical insurance thru my wife's employer. She works at the hospital I just had my surgery and I had my 20 percent waived because she works there. I am very very very thankful for that.

    I would say, tho, to have your son look into a supplemental plan. That may be the best option and would probably cost a whole lot less in premiums than the 20 percent he'd have to pay after surgery.

    I hope this helps you.
  • My brother in law just faced this same issue. He was able to go to a social service office in his county and get his surgery covered 100%
    Look in your phone book for health and human services or social services in the government listings. Hope this helps your son.
  • You've got my brain working in the right direction now!

    Yes, GreyEagle his boys get a check every month too (that is figured into the $1000 a month). I am so sorry to hear your daughter has MS. My sister has it and it is very disabling.You are very lucky to have good insurance through your wife.

    I'm not sure he could get a supplemental insurance policy for this surgery next month and he has no way to fund it but I have checked the Medicare site and he may be eligible for Medicaid too. If not the United Way will hopefully point me to an organisation that can help.

    Thanks again for the ideas! Funny you both have Grey in your names... B)

  • Hi Peggy,

    Some good suggestions were offered, it may be worthwhile to see if the surgeon, etc. would be willing to waive the 20% given your son's financial issues and that he's also trying to support his children on a very small amount of money.

    I found out w/ receipt of a bill ($7.000 +) weeks after my surgery that the neuromuscular monitoring that was done during surgery used an MD out of network which I hadn't been told of or asked if it was OK. I was able through phone calls to my surgeon's office and the neuro office to get the neuro to accept whatever my insurance paid him as payment in full.

    Hope this helps, please let us know how things go.

  • Good idea pfd! We will see what they have to say and report back. I was surprised to hear that they don't need authorisation from Medicare to do the surgery. I thought ALL surgery had to be approved by insurance providers but what do I know!

  • I forgot to ask how you are doing almost one year after your surgery pfd?
    Hope you are doing well.

  • No apology necessary, I'm doing very well, am world's better than last year and have virtually no pain now. My next hurdle will be next month's one year check, hopefully, I'll get a good report.

  • happy to hear you are doing well. May you continue to improve every day!

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