My jaw surgery is OFFICIALLY SCHEDULED!
And…INSURANCE WILL COVER IT!
Wow, it’s been a wild ride since my last update–and this post will be full of even more evidence of God’s incredible mercy and provision!
So, as I talked about last time, Nicole (at my surgeon’s office) was pretty sure my insurance would NOT cover my surgery. They submitted the paperwork, and we entered yet another waiting game. While we were waiting to hear from insurance, a few more issues arose.
1. My surgeon’s office announced they were dropping my insurance company as a provider on January 1, 2012.
2. My current insurance policy is an EPO…meaning I have to see an in-network provider. Once Jan. 1 hits, my surgeon will be out of network. Since there are other maxillofacial surgeons within a 50 mile radius of my home, I would have to see one of them for my surgery if I’m not able to have it this year. (In case you’ve never been through a multiple year ordeal with a doctor you’ve really established a relationship with and whom you trust, let me just tell you: This. Would. SUCK.)
3. If I chose to upgrade my insurance to a PPO (meaning I can pick my own doctor), my premiums would more than double for 2012.
4. Even if I did switch to a PPO, there’s a huge chance insurance will not cover my surgery, no matter the fight. SO, that means I’d be paying higher premiums AND paying for surgery out of pocket. Again, this would suck.
As my husband and I were considering all of these issues, we were still at the mercy of insurance. Maybe, just maybe, they’d approve it on time and I could get surgery in 2011. I was in regular contact with my surgeon’s office while we were waiting to hear, and on November 8th, Nicole informed me that insurance had requested more information about my case!
I started dancing.
I’m not kidding.
Insurance requesting more information meant that they were seriously considering my situation, and needed more of my history, which they send to an RN for consultation. This was an absolutely incredible development! However, there were only TWO surgical spots remaining with my surgeon for the rest of 2011.
So, I became Lindsay the Squeakiest Wheel In Town. I immediately called my insurance company and bugged and asked questions and nagged and asked to speak to someone else. I did this every day for a week. I called on my lunch break. I called after work. I called on my day off. Every time, I got a little bit more information…but never an answer. Finally, one (exasperated) agent told me that they could not speed up the decision making process on my case unless my surgery date was within 72 hours.
Well. Thank you very much for THAT helpful bit of information!
What did I do? I called my surgeon’s office and asked Nicole to move up the date of my surgery to three days from that day. (By “date of my surgery” I mean the fake date surgeons are required to give insurance, even though everyone knows the dates are arbitrary and will change the moment insurance makes a decision.)
The next day, I called insurance again…and MY CASE HAD BEEN APPROVED IN FULL!!!!!!
I immediately ran to tell every single one of my coworkers, who, God love ’em, rejoiced right alongside me.
The remainder of that day, I bugged my surgeon’s office, trying desperately to get on the schedule for December. Sadly, every slot had been filled. But Nicole, God love her, spoke with the hospital and Dr. D’Addario and managed to get me booked for a very unorthodox surgery time of 3:00 pm on December 28, 2011. (They never perform surgery after 12 noon because patients aren’t allowed to eat or drink after midnight the prior night…meaning I’ll be starving and dehydrated, but I’ll be THERE!)
And now for a rousing, GO GOD!
Things have worked out absolutely amazingly. Not only am I actually GETTING jaw surgery, it is single jaw surgery. And it will be covered by insurance. AND it will be this year! That means I don’t have to pay the higher premiums of the PPO plan, and my yearly out-of-pocket maximum under my current plan is only $1,500 (some of which I’ve already paid).
So…bear with me here…the original estimation of surgical costs (out of pocket) for me back in the 2-jaw surgery days was about $50,000. Then my surgery became a one-jaw, which dropped me down to $15,000 out of pocket. NOW, I will not pay more than $1,500.
I am amazed and humbled by God’s incredible and extravagant provision for me in the last few months (not to mention every other moment of my life). I’ve not only seen His greatness in the details of my surgery and insurance, but I’ve seen an outrageous outpouring of love and support from my friends, family and coworkers. I can’t believe jaw surgery is now a reality for me. I just can’t imagine my life any differently than it’s been in these last ten, painful years. But I can believe that this is God’s plan, that He’s blessed this whole journey, and that He is with me every step of the way. For the many ways my faith and courage and hope have been tested in the last ten years, it is so encouraging to be here now, and to see His grace so manifest.
And so, it begins! Or rather, the end is near! I will continue to update this blog throughout the next few months, so stay tuned. I promise I’ll even post some post-surgery pictures…if I feel like showing my chubby cheeks to the world. 🙂