By Mena and Dave SpraguePublished: The Independent in Grand Island, NE, Saturday, November 21, 2009 12:29 PM CST
In November, 2007 our doctor suggested we have colonoscopies, but he told us to call Dave's insurance first to see if they would pay for it. We called and they said, yes, we pay according to the policy.
In February, 2008 Dave had x-rays and an MRI that diagnosed hip replacement was necessary. He now has a "pre-existing condition." Our hospital tried for eleven months to collect the payment on the colonoscopy, but United Health Care choose to pay for the cheaper and later tests and they will only pay for one diagnostic test a year. We paid for the colonoscopy.
Then in December, 2008 Dave saw a specialist and he recommended a steroid shot in the hip, we told him about Dave's poor insurance coverage, so the hospital called and United said they would pay for the shot. They paid the doctor's fee of $500.00 and $15.00 of the hospital charge of $511.00 and we had to pay $496.00.
We checked with the policy and it says United Health Care will pay up to $7,500.00 for a hip replacement, we have since received a letter from them saying they now will pay up to $4,050.00 for hip surgery. A couple of years ago a friend had a knee replacement and the hospital charge alone was over $75,000.00. That does not include the doctor's fee, physical therapy, pain medication or aftercare in a medical institution.
Dave went to the internet and typed in "medical tourism" as we had seen this on "60 Minutes." Also a friend in Amsterdam helped with searching and we liked what we saw about World Med Assist. Dave called the toll free number and Wouter (pronounced Vouter) was the representative who helped us. We sent a CD of the x-rays and MRI and copy of the letter given to us by our doctor to them.
Dave had to answer several pages of medical questions in order for the doctor to see if Dave was a candidate for hip resurfacing. In layman's terms hip replacement is cutting off the femur to put the artificial hip in it, hip resurfacing is leaving the bones intact, there is a spike that goes into the bones. The appliances are smaller and less invasive and you have more mobility after the surgery.
We received word that Dave is a candidate for hip resurfacing and we needed to pick a date. The end of this summer, it was evident that the hip had worsened. If one needs pain pills to walk to the barn, then it is time to do something.
Also while visiting our cousins in Colorado in September, Andrea, who is a registered nurse with her Masters degree, suggested one can have medical complications from pain medication. So Dave decreased the amount of medication he as taking. He was walking with a very bad limp.
Mena checked her schedule, she could travel between Nov. 4th and returning before the 20th. Dave choose Dr. De Smet from Ghent, Belgium. Dr. De Smet discovered hip resurfacing and has done over 3200 operations with very good results. Dr. De Smet has renovated a castle into a Villa with his office, laboratory and radiology on the lower floors, plus a pool, sauna and work out room then upper floors are patient rooms and restaurant. It is a bit pricey. Our stay was included in the package.
Wouter called on Friday to say Dr. De Smet is booked but he will call the doctor on Saturday morning to plead our case. We received our call Saturday morning, saying Dave is scheduled for hip resurfacing the morning of November 10, we are to arrive at the Villa on November 9.
World Med Assist then took over, with Anna as our travel agent to make our airline reservations and Janet, a registered nurse, to assist us and to answer all our questions. Anna found reservations for a good price using Memphis as a connecting city going and Atlanta on the return. Having worked for the airlines we knew how Chicago could have a snow storm in November and be closed down for a day.
And they say we don't need health care reform.
(To be continued.)