So I was hit in the face with an astronomical Estimate of Benefits from my insurance carrier after my June 30, 2014, surgery. The breakdown was: surgery, anesthesiology, pathology, etc. was approximately $71,000! (Insert double-take here) After the insurance company applied their deductions and waivers, the remaining bill was $13,000. The insurance paid for a little over $12,000 of that bill and my my out-of-pocket costs were $800. Which I readily paid! (It really is a depressing sign of the inflated costs of American healthcare)
BUT what happens if you need a robotic laparoscopic excision surgery for Endometriosis and you cannot afford the hefty bill? It’s a question I’m concerned about given the fact that women with Endometriosis routinely require multiple excision surgeries. What happens if my insurance denies the next one? Or my insurance plan changes? Or I suddenly become unemployed?
None of these options are ideal, nor a certainty, but they are better than no options:
Talk to your doctor, your surgeon, and the facilities. See if they offer any type of financial assistance, grants, or payment plans. Some facilities offer layaway plans where you make pre-payments; some may be willing to negotiate if you can pay some cash; some offer discounts; some offer financial aid; and some even pay for a portion (or all) of the procedure if you meet their eligibility requirements. You will never know unless you ask. And each facility and physician will be different. ASK! Talk about it. Don’t just assume you’ll be denied this opportunity.
Medi-Cal, Medicare, Medicaid, or similar governmental aid may be an option if you meet the general requirements.
There are plenty of online fundraising websites out there. Gofundme.com for example, or Giveforward.com. You can lay out your story and your needs; share online with friends, family, and strangers; and keep everyone apprised of the progress of your fundraising efforts. Most sites will take a small percentage fee of the money raised as their share of the goods. Old fashioned Car Washes or Baked Sales are still in style, too. Every little bit helps…Enlist friends and family to help with the outreach, too!
Get a loan
Scary! But, an option. Make sure the loan amount would cover not only the surgery bill, but that of the anesthesiologist, facility, pathologist, support staff, equipment, etc. Have a detailed conversation with your surgeon and/or hospital about the costs associated with your pending surgery. Talk to your banks, credit unions, loan sharks, lending companies, and credit cards companies. Be wary of the interest rates. I would consider this a last ditch effort…
Curious as to the financial assistance offered by my facility where I had my surgery, and will likely have my future surgeries (Scripps in La Jolla, CA), I looked them up and learned that they offer various financial aid options (but only for the facility; NOT for the surgeon…again, talk to all parties involved prior to surgery):
1) Full or partial charity care based on family size and household income;
2) Cash pay programs which offer discounts to uninsured patients, regardless of income level;
3) Interest-free and extended payment plans.
I now know that I can ask about financial assistance through the facility and physicians. And I also know that, if worst comes to worst, I can seek a loan through my local credit union, which is something I never would have thought of. Hoping this brings a bit of peace of mind to any of you reading this that may be in situation where surgery costs are looming over your head…
(Updated June 26, 2019)
Hospital for Special Surgery
~ Again, I am a layman. I do not hold any college degrees, nor mastery of knowledge. Please take what I say with a grain of salt. If curious, do your own research 😉 Validate my writings. Or challenge them. And ALWAYS feel free to consult with your physician. Always. Yours ~ Lisa