Day 32 of officially being on the donor waiting list for the bone and cartilage transplant of my knee. C'mon, the next Kobe Bryant has got to expire soon! God rest his soul.
Insurance update: How exciting, my wonderful insurance company, I won't name any names, Anthem Blue Cross, has decided they don't want to pay for the surgery.
Here's how the process has gone: The insurance company denies. Tons of red tape, paperwork, letters to the California State Board of Insurance, an independent medical review by three orthopaedic surgeons deciding whether or not the insurance company denial should be upheld. Two out of the three say NO GO.
Why?
1. My advanced age of 52 (age discrimination is illegal)
2. They consider the graft experimental (it's not as it has an insurance code)
Bottom line: They will be happy to pay for a healthy, high functioning, high level athlete who has taken amazing care of her body all of her life to have a knee replacement which includes screws, bolts, metal and drilling instead of the graft which will prevent a knee replacement. Why? Gee, could it be because it actually might work?
I give my surgeon, Dr. William Bugbee, a lot of credit for forging the way and being a leader in his field. He's actually trying to help patients have a better quality of life without turning them into living breathing Frankensteins complete with metal bolts protruding out of the sides of their necks. What a concept.
By the way, for those interested in how much the "rich doctors" make: the surgeons portion of this expensive surgery is only $2,500
So folks, here's my plan: Next lifetime, I am going to come back as a high priced Beverly Hills plastic surgeon. Here are the benefits:
• No fooling around with pesky insurance companies
• My average fee for a boob job, face lift, tummy tuck, eyelid surgery will be around 15K
• I will have patients lined up at my door, begging for me to work on them
• I accept cash, 90 days same as cash and all major credit cards, including American Excess!!!
You can't beat that with a stick.
haha! Yer so funny. Happy you're back. But not happy about your knee. Booo! Hiss! Insurance companies suck worse than my vacuum cleaner!
ReplyDeleteUGH! We have BC too...I am NOT a fan. I was worried they would not aprove my Synvisc injections because well, they suck! Grrr...
ReplyDeleteI know you ahve been through alot with your knee...have you ever done Synvisc? I am having BOTH knees done at the same time (since I am not running anyways, poo)Supposedly it works pretty well...the alternative will be knee replacements somewhere down the line(I am watching your experience as this will be me in the future!)
Praying for a good knee to come your way!!! :)
i'll keep my fingers crossed for your donor to come soon! too bad the insurance company is making this difficult process even worse, but it seems like you have the right attitude.... "F- em!" It's your life!! how was the mountain biking?
ReplyDeleteRawBody: No, I haven't had Synvisc as I was advised it would only be a band-aid in my case. My sister had it and experienced several months of relief. The allograft I'm having is an amazing surgery. Living bone and tissue. Look Ma, no screws!
ReplyDeleteJosh: The mountain biking was amazing! Since I'm really new at it, as were my two companians, we laughed hysterically at our ineptness. Laughter gets the endorphins going!
The whole insurance industry is such a convoluted mess... It makes me sick sometimes, but I try not to think about it too much since I work in health care, it just fires me up.
ReplyDeleteGood luck sorting out your knee dilemma, I'll keep my fingers crossed for ya!
Yep, its a band-aid for me too...but since I have both knees involved I am ALL about the band-aids for now...but I am watching your process with GREAT interets!!! :) I can't wait to see the outcome...I am sure you will be back at it and better than ever :)
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