Questions to ask when traveling for surgery (Anchorage, Fairbanks: rent, insurance)

[riceme]

Happy, safe, and healthy new year, friends.

Long story short, I tore the labrum in my hip and have been referred to Dr. Nho at Rush Orthopedics in Chicago for surgery.

It seems that I'll end up paying my out of pocket maximum no matter how I do it, so I might as well go to The Guy that does twelve of these surgeries a week instead of Some Guy that might do twelve in his career. I already have a botched labral tear repair of my shoulder under my belt and am not interested in the same result for my hip.

I have a list of questions, but I don't want to miss anything. For those of you who are experienced in traveling for healthcare,

1/ what questions do I need to ask insurance (Premera Blue Cross Blue Shield)?

2/ what questions do I need to ask Rush Orthopedics?

3/ any words of caution regarding insurance pitfalls or loopholes?

For background, a friend took his daughter to Dr. Nho for the same surgery and they had a great experience. They are set-up for fly-in, fly-out, they take care of transportation, and they have an agreement with the university where you can rent a dorm room for 1/3 price of a hotel.

One of my sisters is going with me, but she'll be flying from Humboldt County, California, and I'll be flying from Fairbanks, so that puts a wrinkle in travel logistics on the return for someone that can't get around too well, but I'll deal with it.

[jdhpa]

I don't have any answers to your questions, but I'm very sorry to hear it. I'll be saying a prayer for your speedy recovery.

[Haolejohn]

Meals.
Dorm rooms aren’t typically set up for cooking.

After surgery care.
Dorm rooms are the easiest to access with parking and what not.

[Parnassia]

IME, BCBS (but I was a federal employee so non-fed coverage may be different) often determines whether they'll pay travel expenses based on the procedure, not the provider, plus where you have to go to get it. If its available in Seattle they may not pay the additional expense to travel somewhere else. Don't know, I haven't been lucky enough to need a procedure they'll pay travel for. Maybe you've already asked about all that. Maybe this procedure is specialized enough that only a few surgeons perform it. Maybe approach BCBS from that angle?

Is this doc and hospital on BCBS's preferred provider list or out of network? That will affect the percentage of charges they'll pay.

Other than that, I agree with what's already been mentioned. Accessibility to what you'll need during recovery. Transportation to followups, food, how you need to leave the room you rent, etc. So far, surgeries I've needed to travel for were leg and foot, so getting myself around while staying in lodging provided was more of a problem than it will be for you, and you'll have a "partner" along.

Keep track of your expenses. They could be useful as tax deductions. Wishing you good luck!!

[riceme]

Originally Posted by Parnassia

IME, BCBS (but I was a federal employee so non-fed coverage may be different) often determines whether they'll pay travel expenses based on the procedure, not the provider, plus where you have to go to get it. If its available in Seattle they may not pay the additional expense to travel somewhere else. Don't know, I haven't been lucky enough to need a procedure they'll pay travel for. Maybe you've already asked about all that. Maybe this procedure is specialized enough that only a few surgeons perform it. Maybe approach BCBS from that angle?

Is this doc and hospital on BCBS's preferred provider list or out of network? That will affect the percentage of charges they'll pay.

Other than that, I agree with what's already been mentioned. Accessibility to what you'll need during recovery. Transportation to followups, food, how you need to leave the room you rent, etc. So far, surgeries I've needed to travel for were leg and foot, so getting myself around while staying in lodging provided was more of a problem than it will be for you, and you'll have a "partner" along.

Keep track of your expenses. They could be useful as tax deductions. Wishing you good luck!!

That is all great input - thank you. I appreciate it.

I have yet to be able to have a detailed conversation with BCBS on this subject because of my current work schedule but I'm going to first thing in the morning. I had a cursory conversation with them a while back and the provider and the facility are on their preferred provider lists. I have spoken with the HR director of our benefits program on the subject and she had a similar situation last year and assured me that everything would work out as planned. I had an appointment with one of the providers at Sportsmedicine & Orthopedic Surgery and she said the same thing and that this is indeed how it works. However, I am not a very trusting soul, which is part of why I'm asking you all for your experiences and feedback.

In general, our insurance claims that we can fly "anywhere" in cases such as this to whatever in-network provider & facility we choose. I do not trust either HR or the insurance company and expect there to be some pitfall or loophole that I'm made aware of after the fact, "well yes we did say out of pocket maximum, but the maximum doesn't include this particular $20k expense that you're now on the hook for" sort of BS. To be fair, my best friend just flew to the states for surgery and everything went perfectly smoothly, but his choice was Virginia Mason in Seattle, so that seems like a huge difference than my own choice.

To get to the nitty gritty: if I went to an FHP provider, I'd pay deductible + 5%. FHP doesn't have a provider that will perform this surgery, so I advance to the next tier: an in-network provider for deductible + 30% which will be my out of pocket maximum. If it was a hip replacement, I might consider Prevost, but it's not, and as I mentioned, I already have one failed labral tear repair and I am significantly less than anxious to pay for a second.

I am not quite as concerned about the logistics in Chicago as I am about logistics after I get home. My friend explained their program to me and I feel comfortable with what he told me, plus my sister will be with me. But I live by myself in a small cabin with a loft and stairs that lead up to my deck and there's a ladder/stairs that go up to my loft where I (usually) sleep. So, I have questions for both insurance and the surgeon about those sorts of things - transportation to/from PT and appointments, whether I'll be okay out here by myself or if I need to stay with my family for a while, how long will it be before I can go up/down stairs,...

I am very independent and more than a little stubborn about it, so that will not be a small hurdle for me.

Really good input. Thanks again. I really appreciate it.

[riceme]

Originally Posted by Haolejohn

Meals.
Dorm rooms aren’t typically set up for cooking.

After surgery care.
Dorm rooms are the easiest to access with parking and what not.

Thank you - this is good stuff.

My understanding is that there is a shared kitchen area in the dorms, but honestly, I was kind of excited about delivery opportunities in Chicago. My sister and I generally have the same eating program, so that will be helpful. She loves to find cool whole foods grocery stores, so that ought to help.

Adding an inquiry about the kitchen situation and parking/accessibility to my questions to Rush Ortho.

Thank you - I appreciate this.

[Haolejohn]

Originally Posted by riceme

Thank you - this is good stuff.

My understanding is that there is a shared kitchen area in the dorms, but honestly, I was kind of excited about delivery opportunities in Chicago. My sister and I generally have the same eating program, so that will be helpful. She loves to find cool whole foods grocery stores, so that ought to help.

Adding an inquiry about the kitchen situation and parking/accessibility to my questions to Rush Ortho.

Thank you - I appreciate this.

Yeah. Food. Lol.

My wife was doing a surgery down south and it ended up being canceled because of her mast cell disease. I was looking forward to eating out every day. Lol

[riceme]

Originally Posted by Haolejohn

Yeah. Food. Lol.

My wife was doing a surgery down south and it ended up being canceled because of her mast cell disease. I was looking forward to eating out every day. Lol

Dining in Chicago (even delivery!) seems exotic and luxurious, and honestly I kind of figure if I'm going to be kicking-down the cash for surgery, we may as well enjoy some good food while we're there. Let's be real, here - I live in the Goldstream Valley. Dining in Anchorage seems "exotic and luxurious," so Chicago is going to seem like another universe.

Actually, that is a good point and not one that I had yet considered. I need to mentally prepare myself for being around traffic, etc. I have a hard time in Fairbanks during "rush hour" and downtown Anchorage is positively terrifying, so it's probably a good thing my sister will be driving. Lol

I hope your wife is okay <3

[Haolejohn]

Originally Posted by riceme

Dining in Chicago (even delivery!) seems exotic and luxurious, and honestly I kind of figure if I'm going to be kicking-down the cash for surgery, we may as well enjoy some good food while we're there. Let's be real, here - I live in the Goldstream Valley. Dining in Anchorage seems "exotic and luxurious," so Chicago is going to seem like another universe.

Actually, that is a good point and not one that I had yet considered. I need to mentally prepare myself for being around traffic, etc. I have a hard time in Fairbanks during "rush hour" and downtown Anchorage is positively terrifying, so it's probably a good thing my sister will be driving. Lol

I hope your wife is okay <3

Traffic. Yes. I. Hate. It.


Wife is ok. We live close to care now. It’s like allergies and she can’t do hardly any foods she used to enjoy. No spices. No garlic. No onions. It’s sucks food wise.

Shoot, with anchorage and their covid mandates eating in anchorage doesn’t happen anymore.

[riceme]

Originally Posted by Haolejohn

Traffic. Yes. I. Hate. It.


Wife is ok. We live close to care now. It’s like allergies and she can’t do hardly any foods she used to enjoy. No spices. No garlic. No onions. It’s sucks food wise.

Shoot, with anchorage and their covid mandates eating in anchorage doesn’t happen anymore.

Traffic stresses me out - I'm going to say to an unreasonable level. Actually, it's not really the traffic, per se, it's the stupid, unsafe things that people do in order to get wherever they're going "that much" faster. I don't think it helps that I am virtually never in traffic. I can think of three times in the last several years.

I'm glad your wife is okay, but I'm sorry about her new food choices. Wow, no garlic and spices would be really tough.

I actually ate out in Anchorage early last summer. I took a roadtrip and stayed a night in Anchorage and ate at Club Paris. Best beef steak I've had in eight years, and the service was fantastic. That also happens to be when I nearly got run over trying to cross the street. Holy cow y'all drive fast in town.