How do I get a medical loan for upcoming brain surgery?

April 27, 2009 3:34 PM

I'm having brain surgery and need to get a medical loan for about 150k. Help?

I'm having brain surgery - possibly within the next 3 weeks if I can get everything in order that fast. The price tag is 150k. I'm not sure how much insurance is going to cover, but I am dubious because it is a preexisting condition and I went through a half year where I was uninsured. My husband and I are looking into medical loans. I am overwhelmed by googling. Please, do any of you have any experience and advice that you can share with me about how to do this?

If anyone reading this has ever had brain surgery, please feel free to share any tips on anxiety management, etc.

posted by sickinthehead to health & fitness (20 comments total)

Jesus. Have you talked to a social worker at the hospital about whether or not you can apply for charity care?
posted by availablelight at 3:44 PM on April 27 [1 favorite has favorites]

...It looks like from your question earlier this month that you're enrolled in a PhD program right now-- do you have someone at the university you can talk to about options in the area for subsidized care? Can you work a payment plan out with the hospital where you pay what you can per month for the rest of your (hopefully long and healthy) life?
posted by availablelight at 3:47 PM on April 27

Oh my god, this country is just ridiculous. INSANE.

First, you need to get someone at the insurance company on the phone. You have to have someone assigned to your case, if at all possible. They can walk you through this process - including how much (and what) will be covered, and how to ensure you end up with the least bill possible -- down to making sure all of the nurses and folks working on you are covered 'in network.' Your primary doctor may also have someone working in her office (or clinic) that deals with insurance questions -- find out who this person is now and make them your best friend. Go in to talk to them, etc.

What insurance company is this? Maybe we can track down the name of the person you can call.

I'm really sorry to hear this. And I'd encourage finding someone to talk to about this - a licensed counselor to walk you through mental health support before and after.
posted by barnone at 3:50 PM on April 27

Yes, please do call your insurance -- or better yet, have the office manager of the doctor in charge of your care call your insurance company for you. It's part of their job to find out ahead of time if you're covered, at what percentage, etc. Also contact the hospital to see if there is a patient representative who can help you with billing issues -- finding out what kind of assistance you might qualify for, negotiating fees and payment plans for uncovered expenses, etc.

god, the health care system in the U.S. makes me seethe with rage.
posted by scody at 3:59 PM on April 27 [1 favorite has favorites]

Talk to the social worker at the hospital. This is her job.

I am sorry.
posted by miss tea at 4:34 PM on April 27 [2 favorites has favorites]

Definitely check with the hospital for a patient rep like scody mentioned. When my oldest son had to have brain surgery, the patient rep helped us through literally years of paperwork, payment, etc. Our situation was complicated because he had the surgery at a children's hospital (out of network), and then had to have the procedure done again a couple of months later (when the same hospital was added to the network). Insurance companies have a lot of negotiation room with hospitals, and hospitals are often more helpful with setting up payment plans and lower costs when you are involved from the start.

On the upside, we have a cool video of the surgery that my son likes to watch sometimes.
posted by shinynewnick at 4:36 PM on April 27 [1 favorite has favorites]

If you have life insurance, you could take a loan out against the policy. I think if you have the right collateral, they will give you a loan. But, I think the above posters are correct in suggesting you look into what the hospital and local support groups can provide.

Good luck and god bless.
posted by JohnnyGunn at 4:56 PM on April 27

Hey everyone. Thanks for your supportive and helpful replies so far. I will definitely get more involved with the insurance company - I am the kind of person who dislikes even calling to order a pizza, so it'll be an uphill battle, but it seems that's what need to be done.

No need to feel bad for me - I am obviously pretty damn scared, but I'm gonna get through all right.
posted by sickinthehead at 4:58 PM on April 27

The social worker at the hospital may not be able to help you until you are admitted. In many places (including the hospital I work for in NC), social workers are focused on discharge planning. Get the patient out of the hospital before the cost of their care exceeds their reimbursement. They don't have the time or resources to walk someone through pre-admission planning. This may be different at a large university medical center.

Do get in touch with your insurance company, and keep in mind that the customer service rep you first talk to probably doesn't know anything. Try to talk to a case manager who will be able understand the specifics of your condition and how that relates to your coverage.

The patient rep suggestion is a good one - they usually have more flexibility in what they are doing than the social workers and can be super helpful if you get a good one. You can also try to the patient accounts/billing department at the hospital. Some hospitals have arrangements with finance companies and can arrange a medical loan for you. Most hospitals will also work out a payment plan.

Best wishes.
posted by jeoc at 4:58 PM on April 27

You may be eligible for Medicaid as a medically needy person -- it's meant for cases just such as this, where people who can otherwise pay for their own care have catastrophically expensive needs. Medicaid is the payer of last resort, so first your private insurance will pay their share, and then Medicaid covers the rest (or most of it).
posted by katemonster at 5:07 PM on April 27

A little bit more info on Medically Needy/spend down: here and here.
posted by katemonster at 5:25 PM on April 27

Do what your insurance says to do- like telling them x hours before undergoing surgery, etc. Get the surgery scheduled, have it done, recover healthfully, and then pay what you can, when you can. The worst thing they can do to you is not do the surgery, right?

I'm being flippant, but not so much. NEVER take out a loan for medical debt. Medical debt is slightly less onerous than regular debt (which your loan would be). You'd have to research your state laws, etc.
posted by gjc at 6:09 PM on April 27

Data point: My friend had a grape-sized cyst in his brain removed about 10 years ago, when he was in his early 20s. Understandably, he was really worried and anxious beforehand. After the surgery, his pupils were slightly mismatched and he took anti-seizure medication- we don't cross paths much any more but on Facebook I observe that he now has two lovely kids and he looks healthy and happy in all his photos. Sending Jedi-vibes your way for a good surgery & speedy recovery!
posted by pseudostrabismus at 6:17 PM on April 27

Have you considered Medical Tourism? Basically you travel to a foreign country where medical treatments are a fraction of the cost. Even including airfare, accomodations, etc, it's far cheaper than the U.S. system. For example, "Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain" (from the wikipedia link)
posted by JuiceBoxHero at 6:47 PM on April 27

Get the surgery and worry about the bills later.

FYI, my sis cracked her head and had to have brain surgery to remove a haemorrage, and the bills came to about $65,000. After a couple months of persistent calling, I managed to have all but about $8000 of the bills either sponsored by healthcare foundations (there's apparently a lot of them) or written off / written down (which a lot of hospitals will do, out of compassion).
posted by randomstriker at 6:55 PM on April 27 [1 favorite has favorites]

Patient Advocate Foundation
posted by fructose at 7:37 PM on April 27

Unrelated to the costs, I would suggest getting your own doctor involved in the process if they aren't already. It was an unusual situation for us, in that we traveled out of state for the procedure to be done by a highly regarded specialist (he literally wrote the chapter about the same condition our son had) who luckily went to medical school with a family friend. With that physician being 11 hours away by car, when our son started showing adverse symptoms in the weeks after the initial procedure it was invaluable to have our local physician already informed of everything before the issues came up. He was able to order all the necessary tests to determine another visit to the specialist was required.

For the anxiety involved, nothing will take it away completely, but the most important thing is to have that person there to ask all the questions. No matter how silly the question may seem, either you need to ask it, or have your husband/family member/close friend do that for you. Feel free to MeMail me with any questions that I might be able to answer for you.

This is no doubt a scary situation, but it sounds like you have a lot of support there already. The scariest moment of my life was watching my five year old son being wheeled into the operating room to remove a cyst on his brain, and the second scariest was him being wheeled out with his head all bandaged with compression wraps. I wish you all the best in this procedure, and I smile every single day that I'm out there playing baseball with my perfectly healthy nine year old son.
posted by shinynewnick at 8:54 PM on April 27

Might be a long shot, but if you have a friend or relative who's responsible and good at dealing with bureaucracy, I'd recommend asking them to help deal with the financial paperwork.

Also, I've heard that Intuit makes software for tracking complex personal health expenses and generating the necessary form letters to send to hospitals and insurance companies. I haven't used it, but if I were in your situation, I'd take a look.
posted by zippy at 10:56 PM on April 27

Yoga is great for anxiety and books on tape are great too.
posted by bookshelves at 8:46 PM on April 28

Bookshelves: I used to do yoga all the time, but unfortunately I can't bend over now without it killing my head. :(
posted by sickinthehead at 5:05 PM on April 30