I can't get health insurance - how much does surgury cost?

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pertbj06
New Member


Date Joined Jul 2008
Total Posts : 1
   Posted 7/22/2008 11:03 PM (GMT -7)   
Hi,
I am new to this forum so I will start out by giving everyone a little history about me.  I was diagnosed with Crohn's Disease in 1998 at the age of 16.  I had some pretty rough times when I was first diagnosed but then after a year or two my doctor switched my medication to Mercaptopurine and since then I have been really healthy.  Ever since I have been on this medication I have had no problems with my Crohn's what so ever.  So fast forward to the start of the year.  I graduated college in May of 2007 and was covered under my parents insurance plan until the first of the year.  Well that time came and I found a few companies that said they would insure me.  So I signed up to a Mega health insurance plan being told it would cover my Crohn's and then when I got my plan they told me that my Crohn's had been excluded.  Then I went back and called all the other compaines that said they would cover me with a rate increase and suddenly they wouldn't cover me either.  So now here I am self-employed unable to get covereage for my Crohn's Disease and it is very frustrating.  Also I live in the state of Nevada so there isn't any state programs that i can take advantage of.  So that leads me to my question first off has anyone tried any of those benfit plans to cover there Crohn's and if so how much of the surgury did it cover.  Also I had surgury when I was first diagnosed and don't remember how much it costed because I had a very good insurance policy through my parents and didn't have to pay anything, so does anyone who had a surgury in the last few years have a rough estimate of how much it costed.  I just need to now that maybe through signing up to one of this beneifits plans that if I have to have surgury I am not going to have to personally pay more then $25,000.  If anyone has any suggestions about how to get coverage for Crohn's I am all ears.  Or if anyone has tried one of the many benefits programs and was happy with the service I would love to hear any suggestions.  Thanks!
 
pertbj06

FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 7/23/2008 5:58 AM (GMT -7)   
Could you reduce your hours at your self-employed job and take up a second part time job that offers benefits? Starbuck, Lowes, Fed Ex, and Petco all offer benefits to part timers, last time I checked. Unfortunatly, the only other suggestion would be to marry someone with group benefits. Oh wait, one more, does anyone else work for you? Could you hire a secretary? You could then group insure your business and include yourself on the plan. If you are group insured then you can't be denied for having crohns.
26 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 7/23/2008 6:39 AM (GMT -7)   
Unfortunately this is part of why alot of us are not self employed. We need the insurance benefits.
Forum Co-moderator - Crohn's Disease
We will find a way, or make one.-Hannibal (crossing the Alps in the 15th Century on war elephants) 
Make sure your suffering has meaning...-?
All suggestions/options/opinions are caveated with please consult with your local health care provider...


Chasity102304
Regular Member


Date Joined Nov 2007
Total Posts : 165
   Posted 7/23/2008 1:40 PM (GMT 0)   
I dont have any advice on how to get insurance since I have great coverage thru my husband's employer. I just wanted to share that my bowel resection along with 8 days in the hospital cost a total of $39,000 in July 2007. I wish you all the best luck in finding something that works for you so that you don't have to pay out of pocket. TAKE CARE and GOOD LUCK!
Fibromyalgia DX March 2003
Crohn's DX Jan 2006 (Symptoms since 96-Misdiagnosed as "female" problems-Major flare during pregnancy in 05 which lead to DX)
1st resection July 2007
Currently on Remicade/8 weeks


sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 7/23/2008 1:21 PM (GMT -7)   
I am self employed but one of the contracts I have includes me in their group insurance-that only happened though because it was a long standing contract-and basically they can't do without me and I can't do without insurance-they pay me 50% less per hour that I work for them then my other contract pays per hour but to me its worth it.
Sj

sr5599
Veteran Member


Date Joined Aug 2007
Total Posts : 1202
   Posted 7/24/2008 12:10 PM (GMT -7)   
Mega Health and Life is a scam when it comes to health insurance. They were horrible... Just wanted to send good wishes... I hope something comes up.
--40 year old female, dx as UC in '04 (1st symptoms in '03), switched to Crohn's in '05, 1 fistula, crohn's colitis, limited to large intestine
--rejected (reaction/didn't work): Asacol, AZA, 6-MP, MTX, Remicade, Humira, prednisone
--methylpred - finally off 6/15/08, tried Prochymal in Phase III study (can't wait til it's approved!)
--started Tysabri 3/21/08, started Xifanan 5/24/08 
--single mom to 10-yr-old girl


vadreamer1
Regular Member


Date Joined Aug 2006
Total Posts : 196
   Posted 7/25/2008 12:28 AM (GMT -7)   
I had tests from Jan 05 to April 05. Diagnosed in April 05, with surgery in May 05. Surgery alone was $60,000. I live near Washington DC. The cost of living here is quite high. Get a job with the state of Nevada or the County you live in. Thats the easiest way to pick up insurance.

hendersonjames
Regular Member


Date Joined Sep 2005
Total Posts : 89
   Posted 7/24/2008 7:31 PM (GMT -7)   
A nine-day stay for a resection in a Pittsburgh hospital (just the hospital bill--surgeons, etc. were extra) in April was $257,000 of which my insurance allowed only $205,000.  I've been trying to find out if I was overcharged.

MAG102886
Veteran Member


Date Joined Jul 2008
Total Posts : 674
   Posted 7/24/2008 9:25 PM (GMT -7)   

2 week stay in Mercy Hospital in Pittsburgh and surgery 90k

3 week stay at St Clair Hospital in Pittsburgh no surgery 50k

2 week stay at Canonsburg Hospital in Pittsburgh galbladder removed 40k

Doesnt really make sense to me, I guess it all depends where you live, and the hospital..Both surgeries I and insurance during, but the 50k is coming out of my pocket for the other stay unless the free care fund decides to help me out...such a long and annoying process. 

 


PonyPoo
New Member


Date Joined Aug 2017
Total Posts : 2
   Posted 8/21/2017 7:59 AM (GMT -7)   
I know this is an old thread, but I was wondering if anyone else wanted to chime in with some pricing input? I'm basically hanging out at home getting sicker and sicker and cannot for the life of me get a GI to see me without health insurance. So it's sort of looking like an ER visit is in my future, but I haven't had a job in like 5 years and am "suppose to" be starting my first big girl job as a nurse in like a week but I'm pretty sure at this point that isn't going to fly. :/ sad

So yeah, sick to death, no money, and no insurance, whoo freaking hoo.... (PS. I could totally swing a dr visit or two with help but tens of thousands of dollars is horrifying)

NiceCupOfTea
Elite Member


Date Joined Jan 2010
Total Posts : 10090
   Posted 8/21/2017 9:09 AM (GMT -7)   
You'll get more responses if you make a new thread. I would also make a thread on the UC board as well - the more input the better. I would help you if I could, but I'm from outside the US and not familiar with their healthcare system.
Dx Crohn's in June 2000. (Yay skull)
Tried: 5-ASAs, azathioprine, 6MP, Remicade, methotrexate, Humira, diets.
1st surgery 20/2/13 - subtotal colectomy with end ileostomy.
2nd surgery 10/7/15 - ileorectal anastomosis. Stoma reversed and ileum connected to the rectum.
Current status: Chronic flare. Do I have any other kind?
Current meds: 50mg 6MP; Entyvio (started 3/11/16)

noodlesnoodles
Regular Member


Date Joined Nov 2015
Total Posts : 273
   Posted 8/21/2017 12:53 PM (GMT -7)   
What is the reason you did not enroll in a marketplace plan at the beginning of the year? I know most if not all states offer financial assistance to reduce the premiums if you are low-income. And if you do not have an income at all you would qualify for Medicaid.
28 year old female
Issues began in July 2014
Capsule endoscopy in late March 2017 showed "suspected Crohn's Ileocolitis"
After colonoscopy on April 14, 2017, was officially diagnosed with Ulcerative Pancolitis (w/ backwash ileitis)
Current meds: Apriso 4 x daily, Prednisone 30 mg, Canasa 1000mg suppository nightly, B12 injections monthly, 50,000 IU Vit D weekly
Started Remicade July 11, 2017

BETTY SUE
Regular Member


Date Joined Nov 2015
Total Posts : 232
   Posted 8/23/2017 7:24 PM (GMT -7)   
My son had a illeocecal resection surgery last year (University of Minnesota) and it cost $92,000 and he was in the hospital for 4 days. Prior to that he was in another hospital for six days (Woodbury Woodwinds) for an obstruction and micro tear in his esophagus (from throwing up so much) and that cost $68,000. Thankfully my husband's insurance covered it all. But unfortunately that is simply not the case for a lot of people. I agree with FITZY and if it is possible to take on a part time job that does cover Chron's. I know that is not always possible. Best to you as you navigate this all! As if living with Chron's does not have enough stress associated with it... now you have to figure out how to pay for all of it!
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