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Microdiscectomy with NO Insurance; What Are My Options???

Hello all,

I have a bulging disc at the L5/S1 that was confirmed via MRI. I already tried months of chiro and PT. I have also had cortisone epidurals at the pain site, but none of these options have worked. Today I visited an orthopedic specialist (spine surgeon) as recommended by my doctor and he suggested a microdiscectomy (which I already figured he would).

I have no insurance and doubt any insurance company would take me on since I would be a costly liability with this per-existing condition. I'm just wondering if hospitals work out payment plans for this type of surgery? Does anyone know? Has anyone had this happen to them or someone they know? Any information you can provide is greatly appreciated.
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Comments

  • If you live in the USA you'll be able to purchase insurance for the 2014 year regardless of preexisting conditions. I know thats a long way away. Most surgeons/hospitals will work out a payment plan if you put out so much upfront. You'll just have to call and find out. The good news is, you shouldn't have too long of a hospital stay, and not too long in the OR which are the biggest costs. Best of luck to you!
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • My surgeons are in the private sector and so I paid cash on the barrelhead.

    During other circumstances, I witnessed a person go into the business/financial office of a hospital and negotiate prices on procedures. The prices were not set in stone! You might be able to negotiate some better prices this way.
    -----------------------------
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • So what if I have no money to put down on this surgery and have no insurance? Would a hospital still be willing to work out payment arrangements with me?
  • AllMetal said:
    If you live in the USA you'll be able to purchase insurance for the 2014 year regardless of preexisting conditions. I know thats a long way away. Most surgeons/hospitals will work out a payment plan if you put out so much upfront. You'll just have to call and find out. The good news is, you shouldn't have too long of a hospital stay, and not too long in the OR which are the biggest costs. Best of luck to you!
    I live in the USA.
  • I'm sure it depends on the hospital. What did your surgeon say? Did you discuss with him that you do not have insurance? I ask because if you are wanting to use that surgeon, then you are limited to the hospital(s) he has privaleges at. I'm sure some hospitals are more likely to work with you than others. Is your surgeon (or his practice) willing to work out payments with you? I know they can ask for 100% upfront. I have no idea what that surgery costs, but my sister is a surgeon and ORs charge insurance $100 per minute from the time your bed rolls in till the bed rolls out. A hospital stay is going to cost much more than that (not per minute obviously, just in the thousands). I'm not trying to discourage you, I just want you to be prepared. I hope you and your family will be able to find a hospital/surgeon willing to work out payments you can afford. Otherwise I guess your options are to try the conservative treatments you can afford, including medication until you are able to sign up for insurance under all the new insurance "stuff" coming, starting 2014 assuming it all goes through legislation and implamentation. I know you must be very frustrated. Start making some calls and see what you can find out. If you are comfortable with your surgeon, and are going to have to wait to purchase insurance under the new health system, I highly suggest you stay in contact with that surgeon. I have a feeling there are lots of people in need of care without insurance, so as soon as they are able to get it, there could be a "flood" of people trying to make appointments/schedule surgeries so you are going to want to be an established patient. Hang in there. I do have insurance, but I have an 8k out of pocket max... I did NOT have 8k. I know my surgeons practice asked that I pay1k up front and bill the rest, and the hospital wanted like 5k, I did NOT have it... it was very stressful, but since I did have insurance, and they were paid over a a quarter of a million by my insurance in the end, they were willing to work out the 5k into payments for us. (and I'm not suggesting at ALL that your bill would be nearly that high, that was not including the OR time, but it was including 10 days in an ICU which is big money, you would not have to be in an ICU (hopefully)). I'm sorry this is sort of rambling, I'm just trying to cram it all in. Anyways, let us know what you find out. I do hope you can get some relief soon.

    And just out of curiosity, are you employed? Does your employer not offer insurance?
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • DejaBOOMDDejaBOOM Posts: 6
    edited 04/29/2013 - 11:27 PM
    AllMetal said:
    I'm sure it depends on the hospital. What did your surgeon say? Did you discuss with him that you do not have insurance? I ask because if you are wanting to use that surgeon, then you are limited to the hospital(s) he has privaleges at. I'm sure some hospitals are more likely to work with you than others. Is your surgeon (or his practice) willing to work out payments with you? I know they can ask for 100% upfront. I have no idea what that surgery costs, but my sister is a surgeon and ORs charge insurance $100 per minute from the time your bed rolls in till the bed rolls out. A hospital stay is going to cost much more than that (not per minute obviously, just in the thousands). I'm not trying to discourage you, I just want you to be prepared. I hope you and your family will be able to find a hospital/surgeon willing to work out payments you can afford. Otherwise I guess your options are to try the conservative treatments you can afford, including medication until you are able to sign up for insurance under all the new insurance "stuff" coming, starting 2014 assuming it all goes through legislation and implamentation. I know you must be very frustrated. Start making some calls and see what you can find out. If you are comfortable with your surgeon, and are going to have to wait to purchase insurance under the new health system, I highly suggest you stay in contact with that surgeon. I have a feeling there are lots of people in need of care without insurance, so as soon as they are able to get it, there could be a "flood" of people trying to make appointments/schedule surgeries so you are going to want to be an established patient. Hang in there. I do have insurance, but I have an 8k out of pocket max... I did NOT have 8k. I know my surgeons practice asked that I pay1k up front and bill the rest, and the hospital wanted like 5k, I did NOT have it... it was very stressful, but since I did have insurance, and they were paid over a a quarter of a million by my insurance in the end, they were willing to work out the 5k into payments for us. (and I'm not suggesting at ALL that your bill would be nearly that high, that was not including the OR time, but it was including 10 days in an ICU which is big money, you would not have to be in an ICU (hopefully)). I'm sorry this is sort of rambling, I'm just trying to cram it all in. Anyways, let us know what you find out. I do hope you can get some relief soon.

    And just out of curiosity, are you employed? Does your employer not offer insurance?
    I am comfortable with the surgeon I have chosen, however he said that it is up to the hospital how they work out a payment plan, IF they do. I am employed. I am an IT contractor for an IT staffing firm. We, as employees, are offered insurance so long as we are working on one of their contracts that is at least 3 months or more. However, once that contract is up, so is your insurance. I had insurance since I was working under one of these contracts, but that insurance ended as of March 28, 2013. Now I know what you're probably thinking... Why not get COBRA coverage to extend your benefits? Well, because when I signed up for insurance I decided to not go for the highest plan or the lowest plan. I instead opted for the middle PPO plan thinking that would be more than sufficient. A microdiscectomy is typically considered an outpatient procedure. Well my insurance required me to pay a $250 deductible, okay so that sounds reasonable, right? But the max amount they would cover was $1,500 (and yes, the comma is in the right place there). So, really, what's the point of payin outrageous premiums for COBRA? You know?
  • DejaBOOMDDejaBOOM Posts: 6
    edited 04/30/2013 - 5:02 PM
    So the orthopedic specialist's admin assistant called me today. She gave me the medical code for the surgery I would need. She informed me that the cost for just the doctor alone (NOT including the hospital's fees, etc.) would be $12,000 and that I would need to contact the hospital to see what their fees for this procedure would be. She speculates that there will be payment plan options for both the doctor's office and for the hospital. I'm sure the hospital's fees will be outrageous as well. Any ideas on how I might be able to cut these fees down? I'm still attempting to apply to multiple insurance companies, but am pretty sure no one will take me with this pre-existing condition.
  • LizLiz Posts: 7,904
    I am sure that you will find your time on Spine-Health very rewarding. This site is a powerful and integrated system that is dynamic and continues to grow.
    Here are just some of the highlights:

    - Detailed medical libraries of Articles and Videos that address almost every Spinal Conditions and Treatment

    - The Wellness section contains articles, tips and videos to help patients after surgery and also to help people avoid surgery.

    - Under the Resource tab, there is a section Doctor Advice Health Center which can be invaluable.

    - As a bonus, Spine-Health provides these patient forums. Here is where you can meet thousands of other people who understand and can relate to your situation. You will soon become part of the Spiney family who provide comfort and the advantages of a Support System. You are now part of this family that is approximately 20,600 International members and growing daily.

    - It is very important to understand the Forum Rules to make sure all of your posts do not violate any of the rules.

    - As a new member, it is helpful to understand the 'makeup' of these forums, how to make posts, tips on adding images and much more. You should read Forum FAQ

    If you have any questions or need assistance, you can use the Private Message facility to contact any one of the Moderators on my team:
    dilauro , tamtam or liz

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • I'm suprised by the surgeon's fee.... a microD isn't that long of a procedure.... I'll have to look to see what my surgeon billed. Sorry though I have no idea how you can cut down on fees.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • AllMetal said:
    I'm suprised by the surgeon's fee.... a microD isn't that long of a procedure.... I'll have to look to see what my surgeon billed. Sorry though I have no idea how you can cut down on fees.
    Yeah, please let me know. I'd be interested to find out.
  • Just as an FYI....I had a lumbar fusion with posterior pedicle screws 3 weeks ago. I don't have a bill from the neurosurgeon or anesthesiologist yet. I got my bill from the hospital last week; it was $98,675. I spent 4 days as an inpatient, although my room and board was less than 3k. The biggest expense at 44k was the instrumentation and up implants they used. I would definitely treat myself as a client and negotiate a non-insurance rate, they should be able to do that. When you go to a plastic surgeon as a private pay, the cost is reduced by about half. Good luck!
    Shari
    Lumbar laminectomy L-4/L-5, 2006
    XLIF with posterior pedicle screws L-4/L-5, 4-23-2013
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