Thursday, April 9, 2009

the options, as I see them

For the most part, I am feeling better. Maybe better isn't the right word - I'm feeling numb. In spite of everything, I am trying to think positive about everything. My husband reminded me that I spoke to a customer service representative, not an expert in insurance and in private insurance agencies like my school district. AND... even if that is the case, there may be a way around it. And if there's not, well... I'm researching other options as we speak.

Some findings today: in California it's against the law to deny a patient orthognathic surgery? I looked for laws similar to this in Washington, but there weren't any to be found. It's looking like private insurance really isn't an option for me. I have researched countless plans - Kaiser isn't available outside of southwest Washington, Regence has an exclusion, Assurant has a $500 dollar maximum payout for jaw related surgeries (HA!), Lifewise has an exclusion, Premera Blue Cross has an exclusion.... and those are the major companies in WA.

I am not ready to quit my job for this. Now, the quick of the matter is that I am also not ready to spend the next year with the same jaw pain and migraines. My jaw pain is becoming more and more severe every day, and it's driving me crazy. I mean, I have never been in this much pain in my life - and that includes 6 years with carpal tunnel and tendonitis - so bad that I had to take a quarter off of playing my clarinet in college because I couldn't open doors with doorknobs or put my hair in ponytail - my fingers and wrists were too sore and stiff. So I've been in pain before. This is so. much. worse.

Another option? Having surgery outside of the US. But I'm not even sure of how to go about this - do I call an individual surgeon? Do I have to call a hospital? How do I pick a surgeon without the help of an orthodontist? I would have the surgery in Canada because I'm relatively close living in Washington state. It wouldn't be out of the question to drive up there and spend a few weeks, and I can always fly back for post-op appointments.

Another option could possibly be the army. Nick is currently just in a 9 week school, but his next school places him in active duty for at least 48 weeks, possibly more. Maybe I can somehow be covered by the army insurance? Do I really want an army surgeon doing my surgery? The only time I went to see a doctor at Madigan I had bronchitis. I used to get bronchitis at least once a year, so I knew what it was - no doubt. After I told the doctor this, he listened to my chest, wrote me a prescritption for ibuprofin and told me I had a cold. A week later I was in the emergency room because I couldn't stop coughing - and it had turned into pnemonia. Needless to say, I don't have a lot of faith in the army medical system.

Otherwise... I wait until Nick is done with language school and hopefully gets a job with good health insurance? But that's at LEAST a year from now. Probably more.

And there are my options, as I see them. In the end, I'm just praying that my school district sees me behind the millions of dollars this is probably going to cost. I'm praying that they say yes. Because I don't know how I'm going to handle it if they do say no.

It kind of feels like I've jacked karma somewhere along the line - I spend 5 years at college doing everything I can to make myself a good teacher and a good candidate to hire. I spend my first two years out of college working in random jobs outside of my comfort area - not to mention one was a long term sub job and one was a leave replacement contract. So now I've got a job with wonderful kids in a wonderful location and a continuing contract... but for some reason this district doesn't use the bloody union insurance - the perfect insurance that covers everything I need at 95%.

Alright, I'm done with the depressed musings now.


funkyrhodes said...

Wow, that is so strange that Kaiser only covers a corner of a state...what's up with that??? I know the options appear to be slim, but keep digging! You may have to research every insurance company out there, major or not. How much would it cost if you went to Canada? I'm still hoping that everything will turn out for you! Don't give up!

Rainne said...

Well, for one, I HIGHLY doubt that it will cost millions. Organ transplants with weeks of hospital stay cost hundreds of thousands. I suspect you're looking at no more than $20,000, even if something goes terribly wrong.

My cosmetic surgery cost just over $10,000. I had complications and had to stay in the hospital an extra two days and have emergency surgery and a blood transfusion, and that was another 10 grand.

I would strongly suspect that you'd be looking at $10-15,000 for all costs, total, hospital stay and all. How many days would you have to stay? Have you asked your surgeon what it would cost if you paid for the entire procedure out of pocket, including hospital stay? I can guarantee they have a good idea, even if they can't give you exact costs.

Does that make you feel better? To get your school district to pay will be thousands, not millions.