Insurance!

This wouldn't be a real surgery without a little "runaround" by an insurance company (only true in the U.S., of course). I had mentioned in my last post that my surgeon's office had re-submitted my case for pre-approval with my insurance company (Anthem Blue Cross). I received the approval letter on Monday... yay!!! I skimmed it and saw phrases like: "medically necessary" and "certified" and "You have chosen to receive services from a provider that is a non-participating network provider. Your services could result in significant out-of-pocket expenses."... say WHAT? I immediately called them, was on hold forever and the first agent I spoke to said "the doctor is contracted in New Hampshire, but your policy is California. Sorry." Without going on and on here about all the different people I spoke with and all the different things they told me, I will fast forward... The last person I spoke with assured me that my policy DOES cover out-of-state "in network" doctors. I finally got a hold of the department that issued the letter and they looked up my doctor while I was on the phone with them and agreed he is, in fact, "in network". (They had his first and last name mixed up, Henry Charles, rather than Charles Henry which is why he wasn't listed as a provider!) They've re-issued my letter and it't in the mail... So, to make a long story longer... I'm approved and my insurance will cover it!

So here's the breakdown with descriptions as they are written on my letter:

reconst lwr jaw w/fixation - Approved

reconstruct midface lefort - Approved

prepare face/oral prosthesis - Approved (splint)

excise inferior turbinate - Approve (deviated septum... i can't breath from my right nostril) 

1 day hospital stay - Approved 

2 additional days - NOTApproved

So, my insurance company will cover 70% of my surgery. I am responsible for 30%. HOWEVER, my maximum out of pocket amount is $5800, so that's the highest cost they can bill me for.