Do I get surgery here or in the US?
August 24, 2016 12:53 AM Subscribe
I'm in a very tough spot. Trying to figure out where to get an urgent surgery, while figuring out insurance coverage.
I currently am an American on American insurance who was injured in a serious skiing accident in New Zealand. I'm currently in Sydney.
The situation
---I was just seen by a top leading specialist (referred to me by many) and he said that I need to be operated on ASAP, within the next five days. It's not life threatening, but if I want to regain functionality of my leg, I need to do it within that time frame.
---That would be all dandy...but I'm not covered in Sydney. I got the quote and while it's very expensive it's something I can handle.
--My American insurance doesn't start until 8/30 (so a week from now, and too late as more than five days) as that's when my new job begins. I confirmed that they will cover. I'm going to see if they can change the payroll date but it's unlikely.
My two options are:
1. Get the operation in Sydney
Pros: Top rated surgeon available and can operate. Predictable costs.
Cons: I don't know much about this hospital and anesthesiologist. No chance insurance will cover (in the off chance that they could cover). Will be stranded in Sydney away from friends and family, and it may be a while before I can get home to recover.
2. Fly out tomorrow and get the operation in SF
Pros: If time and money was not an issue, I would hands down go to SF to be with my support network. It's easier to be at home with family. In the off chance I talk to HR and see if they can move my start date earlier to end of this week, there is a chance it will be covered.
Cons: I don't like the idea of flying a long haul flight. They find a blood clot (under the knee so not at serious risk) and I'm on blood thinners right now. I've been told by my GP that I'm okay flying as I'm on blood thinners, but I don't know...I'm worried.
Also, I will find out soon but I'm not 100% sure of the availability of a good surgeon there. We've been talking to someone over there but it's not 100% confirmed, and I will know by tomorrow. I also don't 100% trust this guy - I've heard he's good, but the one in Sydney is a top leader in his field. He's also 71 so he seems old?
I would need to decide this by tomorrow 830 AM Sydney time to make the flight out (I'm already booked on it).
I just feel super stressed, stranded, and scared that I will make the wrong decision and I want to emerge from this healthy and with the full use of my leg.
My Mom is leaning towards the US option. Usually she has good judgement so I want to go with that, but I'm leaning Sydney because there are fewer risks even if it means I'm stranded (and I will try to just fly out a week or two after my surgery). But I'm just terrified of going with the wrong choice.
I currently am an American on American insurance who was injured in a serious skiing accident in New Zealand. I'm currently in Sydney.
The situation
---I was just seen by a top leading specialist (referred to me by many) and he said that I need to be operated on ASAP, within the next five days. It's not life threatening, but if I want to regain functionality of my leg, I need to do it within that time frame.
---That would be all dandy...but I'm not covered in Sydney. I got the quote and while it's very expensive it's something I can handle.
--My American insurance doesn't start until 8/30 (so a week from now, and too late as more than five days) as that's when my new job begins. I confirmed that they will cover. I'm going to see if they can change the payroll date but it's unlikely.
My two options are:
1. Get the operation in Sydney
Pros: Top rated surgeon available and can operate. Predictable costs.
Cons: I don't know much about this hospital and anesthesiologist. No chance insurance will cover (in the off chance that they could cover). Will be stranded in Sydney away from friends and family, and it may be a while before I can get home to recover.
2. Fly out tomorrow and get the operation in SF
Pros: If time and money was not an issue, I would hands down go to SF to be with my support network. It's easier to be at home with family. In the off chance I talk to HR and see if they can move my start date earlier to end of this week, there is a chance it will be covered.
Cons: I don't like the idea of flying a long haul flight. They find a blood clot (under the knee so not at serious risk) and I'm on blood thinners right now. I've been told by my GP that I'm okay flying as I'm on blood thinners, but I don't know...I'm worried.
Also, I will find out soon but I'm not 100% sure of the availability of a good surgeon there. We've been talking to someone over there but it's not 100% confirmed, and I will know by tomorrow. I also don't 100% trust this guy - I've heard he's good, but the one in Sydney is a top leader in his field. He's also 71 so he seems old?
I would need to decide this by tomorrow 830 AM Sydney time to make the flight out (I'm already booked on it).
I just feel super stressed, stranded, and scared that I will make the wrong decision and I want to emerge from this healthy and with the full use of my leg.
My Mom is leaning towards the US option. Usually she has good judgement so I want to go with that, but I'm leaning Sydney because there are fewer risks even if it means I'm stranded (and I will try to just fly out a week or two after my surgery). But I'm just terrified of going with the wrong choice.
If there's anything random internet strangers who live here in Sydney can help with, memail me! Happy to visit, bring you things you need, organise a metafilter meet up at the hospital, etc.
posted by lollusc at 1:44 AM on August 24, 2016 [36 favorites]
posted by lollusc at 1:44 AM on August 24, 2016 [36 favorites]
Yup. I'll visit too. Used to work in many Sydney hospitals. Possibly even know your orthopod. You could possibly even negotiate down the fees if you mention your lack of insurance. If you want a friend to phone here, memail me.
posted by taff at 1:51 AM on August 24, 2016 [18 favorites]
posted by taff at 1:51 AM on August 24, 2016 [18 favorites]
Not to add to your costs, but if you have the operation in Sydney, could you pay to have your mom or another family member or friend fly to Sydney to be with you? Last-minute flights to Sydney from LAX, for example, are about $1200 right now. Not free, but if folded into medical costs, certainly not outrageous. (And, I have to imagine, far cheaper than the cost of a major operation without insurance in the US -- not sure how Australian medical costs compare.) That way, you can have a familiar face for helping you during recovery but also get the surgery done ASAP and not have to worry about flying and delay.
posted by HonoriaGlossop at 2:00 AM on August 24, 2016 [3 favorites]
posted by HonoriaGlossop at 2:00 AM on August 24, 2016 [3 favorites]
Don't you have travel insurance that would cover you?
posted by ryanbryan at 2:06 AM on August 24, 2016 [2 favorites]
posted by ryanbryan at 2:06 AM on August 24, 2016 [2 favorites]
Response by poster: No travel insurance (I know, stupid mistake).
posted by pando11 at 2:18 AM on August 24, 2016
posted by pando11 at 2:18 AM on August 24, 2016
Yeah, if you don't have travel insurance, I would still go with Sydney. FWIW, I paid out of pocket for ACL surgery after an accident in the UK, very far from family and with a very small amount of support.
However, you do need support. You need somebody, even a few hours a day. I hired a home health aid. She came, made me lunch, tidied the house, and helped me shower. She also brought in the most basic groceries in the world from the corner shop. I lived on tinned soup and sandwiches (it was fine.)
And you need somewhere to stay.
posted by DarlingBri at 2:41 AM on August 24, 2016
However, you do need support. You need somebody, even a few hours a day. I hired a home health aid. She came, made me lunch, tidied the house, and helped me shower. She also brought in the most basic groceries in the world from the corner shop. I lived on tinned soup and sandwiches (it was fine.)
And you need somewhere to stay.
posted by DarlingBri at 2:41 AM on August 24, 2016
Since you had the accident in NZ, would ACC cover you to have treatment in NZ?
posted by oceanmorning at 3:11 AM on August 24, 2016
posted by oceanmorning at 3:11 AM on August 24, 2016
I can vouch for Taff. She's really very nice.
posted by lollusc at 4:42 AM on August 24, 2016 [5 favorites]
posted by lollusc at 4:42 AM on August 24, 2016 [5 favorites]
I know you said you didn't buy travel insurance specifically, but did you pay for your flight to New Zealand with your credit card? Any chance you got automatic travel insurance with it?
posted by Gomez_in_the_South at 4:45 AM on August 24, 2016 [6 favorites]
posted by Gomez_in_the_South at 4:45 AM on August 24, 2016 [6 favorites]
Another Sydneysider, offering to help if I can. My time is limited right now but memail me and I'll see what I can do.
Taff knows hospitals, and came and held my hand in one once (and didn't even steal my wallet). It may help to talk to her.
posted by His thoughts were red thoughts at 5:44 AM on August 24, 2016 [5 favorites]
Taff knows hospitals, and came and held my hand in one once (and didn't even steal my wallet). It may help to talk to her.
posted by His thoughts were red thoughts at 5:44 AM on August 24, 2016 [5 favorites]
Some friends of mine were recently in an accident far from home as well (they're recovering, thank goodness) and staying put really was a better choice for them. Less stressful on the body, more consistent medical supervision. Plus, at the end of the day it was much easier for healthy parents to hop on a plane than it was injured kids. Could your mum go to Sydney?
Also, I know your situation's about a lot more than just insurance, but for as much as the money stuff matters -- you won't miss the cash after a while, but you'd miss the full use of your leg for the rest of your life.
posted by harperpitt at 6:10 AM on August 24, 2016 [4 favorites]
Also, I know your situation's about a lot more than just insurance, but for as much as the money stuff matters -- you won't miss the cash after a while, but you'd miss the full use of your leg for the rest of your life.
posted by harperpitt at 6:10 AM on August 24, 2016 [4 favorites]
We have now texted. I did know her doctor. I worked in one of the same hospitals as him for a few years, met lots of his patients pre and post and know the group he works with and one of his rehab team.
Hopefully she's blissed out on happy drugs for the night. I've assured her she's got a friend (several! many! ) in town for all appropriate support duties if she decides to have the repair done here.
And hopefully the scare factor is now lowered for whichever choice she makes.
(Sydney mefites, prepare to be put on a meal roster! )
posted by taff at 6:15 AM on August 24, 2016 [49 favorites]
Hopefully she's blissed out on happy drugs for the night. I've assured her she's got a friend (several! many! ) in town for all appropriate support duties if she decides to have the repair done here.
And hopefully the scare factor is now lowered for whichever choice she makes.
(Sydney mefites, prepare to be put on a meal roster! )
posted by taff at 6:15 AM on August 24, 2016 [49 favorites]
First, I am with everyone who says don't be thinking about money when something as long-lasting as a functioning leg is at stake.
BUT, if immediate travel is feasible I'd vote for San Francisco, not to save money as because you may have months of rehab and recuperation and could easily need a second surgery. Splurge on a business class ticket to fly in comfort.
You'd like your surgeon to be able to see you again to monitor progress and to conduct any revisions that might be required, and to make sure you are with the best physical therapist or other rehabilitation specialist.
If you're going to need painkillers during your rehab, you can probably forget about getting them if you do the surgery in Sydney -- the paranoia for drug seekers and drug seeker seekers (i.e., cops and the FDA) is so high that you'll struggle to get a pharmacy to honor an Aussie prescription to say the least of getting a new US doctor to give you a prescription based upon a (what he will think) alleged ski injury and surgery half a world away.
posted by MattD at 6:40 AM on August 24, 2016
BUT, if immediate travel is feasible I'd vote for San Francisco, not to save money as because you may have months of rehab and recuperation and could easily need a second surgery. Splurge on a business class ticket to fly in comfort.
You'd like your surgeon to be able to see you again to monitor progress and to conduct any revisions that might be required, and to make sure you are with the best physical therapist or other rehabilitation specialist.
If you're going to need painkillers during your rehab, you can probably forget about getting them if you do the surgery in Sydney -- the paranoia for drug seekers and drug seeker seekers (i.e., cops and the FDA) is so high that you'll struggle to get a pharmacy to honor an Aussie prescription to say the least of getting a new US doctor to give you a prescription based upon a (what he will think) alleged ski injury and surgery half a world away.
posted by MattD at 6:40 AM on August 24, 2016
Definitely, definitely do not fly, ESPECIALLY since you have a blood clot.
And I can't quote comments from my phone, but the above comment about drug seeking is scaremongering. Ignore.
posted by pintapicasso at 7:08 AM on August 24, 2016 [10 favorites]
And I can't quote comments from my phone, but the above comment about drug seeking is scaremongering. Ignore.
posted by pintapicasso at 7:08 AM on August 24, 2016 [10 favorites]
My American insurance doesn't start until 8/30
I feel like I should point out that if your previous job had health insurance, you can retroactively elect to continue that insurance through COBRA up to 60 days since you lost your health insurance. Once you retroactively elect COBRA, your coverage is back-dated to the time you left your job and you will be magically covered immediately (and will now have health insurance at the time of the accident). You can do this even after declining/waiving to continue insurance through COBRA.
I realize this sounds a lot like "cheating", but this is entirely a real thing.
posted by saeculorum at 7:13 AM on August 24, 2016 [17 favorites]
I feel like I should point out that if your previous job had health insurance, you can retroactively elect to continue that insurance through COBRA up to 60 days since you lost your health insurance. Once you retroactively elect COBRA, your coverage is back-dated to the time you left your job and you will be magically covered immediately (and will now have health insurance at the time of the accident). You can do this even after declining/waiving to continue insurance through COBRA.
I realize this sounds a lot like "cheating", but this is entirely a real thing.
posted by saeculorum at 7:13 AM on August 24, 2016 [17 favorites]
saeculorum beat me to it. I don't know if doing COBRA retroactively will apply to this particular situation but it definitely sounds like it's worth a try. Get better soon!
posted by kat518 at 9:29 AM on August 24, 2016
posted by kat518 at 9:29 AM on August 24, 2016
I used to work for a health insurer and just wanted to mention that most employment-based health insurance starts on the first day of the month... either the first of the month which follows the employee's start date, or the first of the month after 30, 60, or 90 days of employment, etc. So if you decide to ask your new job about changing your start date to make your insurance start earlier, be prepared for the possibility that it won't affect your insurance date. Some health insurance does start on the first date of employment but in my experience that's not very common. The COBRA suggestion above is a good one -- and if you're within the date parameters of COBRA from your last job being possible, it'd be worth finding out if that insurance would cover medicine overseas.
posted by cuddles.mcsnuggy at 10:06 AM on August 24, 2016
posted by cuddles.mcsnuggy at 10:06 AM on August 24, 2016
Heya do it in Sydney.
Definitely take taff's advice (on top of her offer!) to negotiate as well. Here in France when I was a poor university student with American healthcare – students don't qualify for French national healthcare – every place I saw waived any fees. A dentist even gently pushed me out the office door before I could ask. For a surgery they may not waive everything, but I'm pretty sure they'd reduce your fee.
There is a lot of goodwill towards Americans in a tight spot who need healthcare. Everyone knows our system is inhumane.
Re: the US option, there WILL be unpredictable charges. Go for Sydney, all the way.
posted by fraula at 12:44 PM on August 24, 2016
Definitely take taff's advice (on top of her offer!) to negotiate as well. Here in France when I was a poor university student with American healthcare – students don't qualify for French national healthcare – every place I saw waived any fees. A dentist even gently pushed me out the office door before I could ask. For a surgery they may not waive everything, but I'm pretty sure they'd reduce your fee.
There is a lot of goodwill towards Americans in a tight spot who need healthcare. Everyone knows our system is inhumane.
Re: the US option, there WILL be unpredictable charges. Go for Sydney, all the way.
posted by fraula at 12:44 PM on August 24, 2016
There will almost certainly be unpredictable charges in Australia as well, but they're not likely to be as bad as the US. There is some degree of financial rorting in the private system, so don't be afraid to challenge the doctor if something doesn't seem right or they seem overly cautious about things. As soon as you're able, go back to the US for any aftercare.
Good luck, and don't ever ever travel without travel insurance ever again.
posted by ryanbryan at 6:38 PM on August 24, 2016
Good luck, and don't ever ever travel without travel insurance ever again.
posted by ryanbryan at 6:38 PM on August 24, 2016
If you're going to need painkillers during your rehab, you can probably forget about getting them if you do the surgery in Sydney -- the paranoia for drug seekers and drug seeker seekers (i.e., cops and the FDA) is so high that you'll struggle to get a pharmacy to honor an Aussie prescription to say the least of getting a new US doctor to give you a prescription based upon a (what he will think) alleged ski injury and surgery half a world away.
Respectfully, I don't think this is going to be a serious problem with medical records to substantiate this kind of injury and surgery. Although it would be good to arrange for your care to be officially 'transferred' to whoever will handle your rehab state-side, if needed.
posted by snuffleupagus at 1:20 AM on August 25, 2016
Respectfully, I don't think this is going to be a serious problem with medical records to substantiate this kind of injury and surgery. Although it would be good to arrange for your care to be officially 'transferred' to whoever will handle your rehab state-side, if needed.
posted by snuffleupagus at 1:20 AM on August 25, 2016
More contact! Meal roster on hold just now. Not my news to tell without permission (I totes forgot to ask!) but let's just say there's a perfect plan and we've got her back in case of need, at a moments notice.
You're good peeps, mefites. High fives all round. And hugs for our poor batterred pando11.
posted by taff at 2:34 AM on August 25, 2016 [2 favorites]
You're good peeps, mefites. High fives all round. And hugs for our poor batterred pando11.
posted by taff at 2:34 AM on August 25, 2016 [2 favorites]
Response by poster: Thanks all! I am currently in the hospital and recovering from surgery. The surgery went very well and I ironically am in much less pain post surgery (I was expecting to be in more). I feel good about my choice. Taff has been super reassuring and made me feel I would be okay if I went with this option.
In the 24 hours since I've posted this, my friend in Sydney rallied and let me stay in his spare room and took me the hospital and got me covered with soothing adult coloring books (highly recommend! Better than reading as you can barely pay attention) and my favorite snacks. My Dad is getting in any minute now. I'm at the hospital for today and tonight and getting discharged tomorrow morning. I am touched by the support of everyone - I would love to meet you all at some point, for now I prefer to be with my Dad in the next few days and meet you guys when I am a little less greasy haired :) You made this decision an easy one. Love Metafilter!
If there is one thing I've learned from this experience, it's that the kindness of strangers can really amaze.
posted by pando11 at 3:58 PM on August 26, 2016 [6 favorites]
In the 24 hours since I've posted this, my friend in Sydney rallied and let me stay in his spare room and took me the hospital and got me covered with soothing adult coloring books (highly recommend! Better than reading as you can barely pay attention) and my favorite snacks. My Dad is getting in any minute now. I'm at the hospital for today and tonight and getting discharged tomorrow morning. I am touched by the support of everyone - I would love to meet you all at some point, for now I prefer to be with my Dad in the next few days and meet you guys when I am a little less greasy haired :) You made this decision an easy one. Love Metafilter!
If there is one thing I've learned from this experience, it's that the kindness of strangers can really amaze.
posted by pando11 at 3:58 PM on August 26, 2016 [6 favorites]
Thanks for updating! Glad everything went well and you are recovering. Please reach out to the Sydney mefites if you need support. And if you're well enough, let's organise a meetup before you go home!
posted by His thoughts were red thoughts at 6:06 PM on August 29, 2016
posted by His thoughts were red thoughts at 6:06 PM on August 29, 2016
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