Can we talk dollars?

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My first OHS cost me nothing. Our insurance paid it all.
My second OHS cost me $5.00..... I never did figure out what that $5 bill was for but it was more trouble than it was worth to chase it down and simply paid it.
About 6 months later, I got a check in the mail for that $5.00. Apparently, I wasn't supposed to be billed.

Two OHS in four years and our insurance paid all bills.
 
Wow!!!! I am blessed to live in Canada, its all covered through my medical which costs me $50.00 a month... MY heart goes out to all of you who have to deal with such huge finanacial stress after having to deal with the emotional part of becoming healthy again. Just doesn't seem fair.
 
Lets see, If memory serves me right the total cost was 145,000. Out of that I had to pay 483.00. Not to bad. I only wish they took care of my aortic root and asending while they had me open!
 
What did you guys pay for meds (pre-insurance) in the first 6 months? I'm trying to estimate what to put into my flexible spending account to cover it. From what I've read it sounds like there are LOTS of medications immediately following surgery.
 
Penny said:
Wow!!!! I am blessed to live in Canada, its all covered through my medical which costs me $50.00 a month... MY heart goes out to all of you who have to deal with such huge finanacial stress after having to deal with the emotional part of becoming healthy again. Just doesn't seem fair.
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I don't believe that anyone who has replied to this thread from the US has actually paid these amounts out of pocket...we just get to see the whole bill that the insurance company is billed. And by the way, there is no such thing as free healthcare. Those of you who live in places where the government "pays" for your healthcare are just paying for it differently than we are...through higher taxes. When we lived in the UK, our tax bill was much higher for the same salary than we pay here for our taxes and insurance combined...plus we get to choose and don't have to wait!
 
There is no free.
We either pay it in insurance premiums or we pay it in taxes.
We are paying for it. Be it VAT, be it income tax, be it capital gains tax, food tax, real estate tax, personal property tax, gasoline tax etc,
We ALL pay for the health care we get unless we are indigent. Then the rest of the tax payers and insurance premium payers pay for that person's care.

Health care is not free anywhere.
In the U.S., depending upon which kind of insurance we choose, many of us have wide freedom to choose which doctors, hospitals, when and where and do not have lengthy waits to see them and schedule whatever tests and surgeries we need. There is a lot to say for that.
 
Cost?

Cost?

The total bill for my AVR was $250,000.00. My insurance was lousy and I was required to pay 20% of the total (that was $50,000.00). In addition to my 20%, I had to hit certain limits on out-of-pocket stuff up front. Insurance didn't really cover lots of the initial costs for the pre-surgery stuff. We spent in the neighborhood of $80,000.00...which we really didn't have. I've commented before that we actually had a discussion about whether we could afford the surgery that would save my life. If you think that sounds overly-dramatic, you should've been at our house for that discussion.

Since some reponses to this post seem to be moving in the direction of editorial comment, I'll add my proverbial "two cents worth"...

Yes, everyone pays for medical care in countries where health care is nationalized. How high the costs are in those places considering taxes vs. the cost of health insurance in the U.S. is debatable. My son and his family emigrated to Canada. The taxes they pay in Ontario are much less than what health insurance was costing them when they lived in Colorado. I can only speak to the experience my family has had.

Health providers in the U.S. cannot deny services to those who need services. Had I defaulted on the $80,000.00 I owed for expenses related to my AVR surgery, who would've paid? The answer is that others would have footed the bill through increased medical costs.

I doubt we'll ever see the controversy over health care in the U.S. resolved until we begin looking at health care as a right rather than a for profit business. Personally, I believe health insurance executives focus on the bottom dollar line rather than focusing upon people. Again, just my opinion, but something needs to change.

-Philip
 
Those in the US saying insurance paid everything or close to it, should factor in the insurance premiums. I paid big premiums for decades and essentially never used the system (never hospitalized) until last year. I figure I finally got my premiums back. And when you add in my son's recent brain surgery (which went well and he should be fine - thank you healthcare system), we are now a pretty sizable net loss to the insurance company, but that's how insurance should work. Those in other countries where government plans cover essentially everything should factor in some part of their taxes. It's remarkable how little taxes I pay despite living in the late, great state of CA, which is about as high as it gets in the US. In fact, in the last 2 years I paid far less than zero due to some tax law changes that ended up refunding me some earlier taxes, and I'm not claiming any weird deductions.

Still, there is a major difference between the US and most other systems. Doctors traditionally have been paid handsome sums in the US and hospitals have been huge moneymaking machines. Healthcare expenses in total consume a far larger percentage of GNP in the US and the costs have skyrocketed for decades at an alarming rate. Although there have been attempts to moderate this, they have been largely unsuccessful and even backfired. I was in healthcare when Medicare started using DRGs (Diagnostic Related Groups) which implemented fixed payment amounts for hospital care by disease state in place of the previous pay-whatever-the-hospital-billed system. That sent huge shockwaves through the health system. But within a year hospitals figured out how to play the DRG system and maximize payments, and over all Medicare costs soared. I shared a hospital room with a guy who had multiple medical problems and had been in and out of the hospital all year and Medicare had spent more than $1 million on him that year.
 
It's been ten years, but as I recall the "retail" price for my AVR was around $125,000, with Aetna paying a negotiated price of around $56,000. My out-of-pocket was only $500, so no complaints.

Mark
 
drivetopless said:
What did you guys pay for meds (pre-insurance) in the first 6 months? I'm trying to estimate what to put into my flexible spending account to cover it. From what I've read it sounds like there are LOTS of medications immediately following surgery.
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I've been lucky that most of my meds are $4 generics. Only had 1 name brand drug that was a $30 co-pay. There were a fair amount of different meds that were being tried while I was still in the hospital. My funds were pretty limited back then and I mentioned to cardiologist that if my meds were going to be changed much, I'd need generics or samples of brand-name meds. I was able to go home with generics.
 
I did not have 'lots' of medications after either of my OHS and I still only take limited meds. I agree some of the med lists I read here seem like lots of pills. Best would be for you to get some sort of idea from your cardio or surgeon what they expect they will want you to take. Not everyone takes piles of pills.
 
Obviously there is no "free" health care, but for me, with my nervous nature, I am glad that my regular taxes have enabled me to have open heart surgery when I was ready, with the surgeon I chose, in the hospital I chose. Receiving a bill for anything afterwards would have put me on suicide watch for sure. ;)
 
I had no idea that this type of surgery cost so much money !? Wow ! I spent 7 days in hospital when I had my AVR, amazing surgeon and aftercare ... The only downside was sharing a ward with several other patients and the food was pretty awful. The total cost to me was nothing, and would still be nothing if I'd been in there for several months. I'm so pleased we have the National Health Service (NHS) here in Britain. I'd be interested to know how much the NHS paid On-X for my valve though ?
 
drivetopless said:
What did you guys pay for meds (pre-insurance) in the first 6 months? I'm trying to estimate what to put into my flexible spending account to cover it. From what I've read it sounds like there are LOTS of medications immediately following surgery.
Click to expand...

It's near impossible to say what you'll be on, if anything.
 
I had AVR at the Cleveland Clinic in November of 2008. I was in the ICU for six days and then another 3 days on the regular floor. The final total came in at $199,000. My insurance paid it all except for a $12,000 deductible, which I spent on pre-op testing (MRI,, cath, etc.)
 
We have always had insurance for Justin. ButJustin has had many surgeries, spent abut 6 months all together in the hospital his first 2 years and 2 heart surgeries as well as pyloric stenotis surgery (he also had over 53 ECHOs before he was 2 the echo tech , who got to know us well "congradulated" us for having the most ECHOs at CHOP, I quit counting awhile ago) those 2 years all we paid was a 10 dollar copay for out patient visits and like 5 dollar co pay for meds when he was home, nothing for anything in the hospital . That was in 88-90 and even then his bills were hundreds of thousands.

The surgeries and hospital stays he has had since then also cost us nothing..even when his hospital was out of Network for our insurance, we were able to get pre-approved (complex case, continuity of care ect) to have it coverred like in network (it was alot of phone calls and letters, but worth it)
The ONE problem/cost we really had to fight was when he was 11 and had BE and on 2 very expensive IV antibiotics he needed to get 3 times a day for 6 weeks, Insurance had a dumb rule they had no problem paying everything IF he stayed in the hospital but wouldn't cover the meds if he went home ,(we didn't even want alot of nursing, we could change the ivs ect) he had to stay 3 extra days while we (including his social worker and docs) had to fight to get those coverred. We even pointed out the money they wasted keeping him in the hospital when he was well enough to go home more than coverred the weeks of IVs, for some reason they couldn't get that. Anyway, we got it coverred and he could come home, this was in about 2000. I was happy/surprised when he had the sternal infection and we were setting everything up to go home, they now coverred home IVs with out a problem. It never made sense to be willing to spend thousands of dollars a day to keep a relatively healthy kid in the hospital for weeks on top of the IV meds/supplies, instead of just paying for the IVs athome and no other cost.
I lost count of how much Justin's bills were (even just for his heart stuff) but when he is in the hospital we don't pay anything. when he is home we pay a 20 dollar co pay.
 
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