Insurance coverage

General
1

good morning,

I have an HMO, live in Cali. i would like to fly to San Jose, Ca to have Dr. Samji preform my surgery; however not sure if my insurance will cover since he is out of my HMO network. Does anyone have any tips or suggestions to fight this? or has anyone paid out of pocket for this surgery? that is how desperate I have become..

Thanks so much for your help

2

Go on to market place and change your insurance pick ppo plan

3

I don't have an HMO, but don't they have procedures for you to see specialists out of the plan if you have a rare condition? Maybe you can look into that.

I live in Hawaii and I've been all over the country to see various doctors about Eagles. I've paid quite a bit out of pocket. I have a PPO and they've covered most of the hospital and doctor bills, but none of the flights and hotels, etc. Unfortunately, I think for a lot of Eagles patients, that's pretty much what we have to do to get this fixed.

I know of one person who paid out of pocket for her surgery. I can't think of her name right now, but she lived either in Europe or South America and came to North America for her surgery. I can't remember exactly, but I think the cost was somewhere around $30,000 for the surgery.

4

Thanks so much for the replies! I really do appreciate it. I will call my insurance company today and ask if they have a procedure for rare conditions.

heidemt said:

I don't have an HMO, but don't they have procedures for you to see specialists out of the plan if you have a rare condition? Maybe you can look into that.

I live in Hawaii and I've been all over the country to see various doctors about Eagles. I've paid quite a bit out of pocket. I have a PPO and they've covered most of the hospital and doctor bills, but none of the flights and hotels, etc. Unfortunately, I think for a lot of Eagles patients, that's pretty much what we have to do to get this fixed.

I know of one person who paid out of pocket for her surgery. I can't think of her name right now, but she lived either in Europe or South America and came to North America for her surgery. I can't remember exactly, but I think the cost was somewhere around $30,000 for the surgery.