September we meet with the plastic surgeon to discuss the reconstruction. We were worried about paying another deductible if this went on after the end of the year. Our doctor spoke with Blue Cross and Blue Shield who assured us since this was a continuing illness which would take several surgeries, there would be NO additional deductible if we finished before the end of the first quarter of 2014. Great, no problem or so we thought.
November 5th she had the surgery to put the Tissue Expanders in to begin gradually stretching the skin and muscle. The surgery went well and she was off work for another 3 weeks. The pain is constant with the expanders, but it's part of the reconstruction process. Every 3 or 4 weeks she has saline injected in each side to graudually blow each breast up. So for the next several months everything is going along fine, especially since by the Grace of God she doesn't have to have Chemo or Radiation, she only has to take the Cancer medicine for 5 years.
Jump forward to February 5th, 2014; we go see the plastic surgeon for the last tissue expander blow up and to schedule the surgery to remove the expanders and put the perminant implants in, which we scheduled for March 4th, 2014, just in time to make sure we are in the first quarter like BCBS told us.
After several days of being so excited to get those expanders out and the implants in, the surgery center informs us there with be $3000.00 for the deductible before the surgery. The doctor has reminded them of the prior approval in September and we have argued the point until we're blue in the face. Their rebutal is that only applies if the deductible for 2013 was paid in the last quarted, it was paid in August. Of course BCBS neglected to tell us opr the doctor this one detail or we would have rushed and tried to get the hole thing done before years end. This is just another example of how we get screwed by the insurance companies. Needless to say Donna was crushed and her once great attitude was knocked down to nothing.
We are trying lawyers and the insurance commissioner, but she can't wait another 3,4,5 or 6 months to get an answer from them or to have those things removed. This doesn't include all the other bills that insurance doesn't cover. I am asking for any help we can get, and I understand there are so many people who are in need and may be in the same boat financially as we are.
Thank you so much for listening,
In His Name.
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