Four days before the surgery was scheduled my insurance company 'unauthorized' it. --- Launa S, WA, USA
Healthbase came up as I researched a bi-lateral hip replacement. An x-ray in September viewed by my local surgeon informed me about my right hip. I had discomfort for years, I thought it was a muscle from daily exercise or cancer which kept me from looking into it. I went for a second x-ray, better quality, both hips and found osteo arthritis in both. That surgeon was not comfortable doing both at the same time even though both hips were severely affected.
A second opinion by a surgeon in Seattle and a willingness to do both, surgery was scheduled for November. The surgeon explained the procedure, the prosthesis choices, mandatory medications, post op. 2-3 days in the hospital, then home. My insurance didn't cover any home help or further convalescing. My daughter would have winter break, this satisfied concerns or reservations in doing a bi-lateral hip replacement. Pre-op work was completed. Four days before the surgery was scheduled my insurance company 'unauthorized' it. They assured me I could do it, they would not cover it. They said there had been a mistake.
I pursued an informal appeal process. There was no guarantee that if I waited for the required pre-existing condition waiting period that the insurance company would cover the surgery. They determined that a prudent person would have known they had osteo arthritis, though I had not seen a doctor or had an x-ray or had any previous medical history.
I was encouraged by my daughter, who coincidentally went to hear the insurance company whistle blower, Wendall Potter, speaking at the Town Hall Meeting. She was convinced I needed to look for my medical care out of the country, where I could afford it. Research began on the internet. Cuba, Mexico, South America, Europe, no surgeons came up as bi-lateral hip replacement, or if they did it meant one hip and months later the other. Doctors Without Borders, a familiar program appeared, with it Healthbase; Moe, a contact person with Healthbase, responded by phone. He was easy to discuss my story with, his understanding manner while informative gave me hope that I found an international medical program offering bi-lateral hip replacement. The surgeon was in Mumbai.
I continued to search for someone closer, the distance seemed impossible, my discomfort level was extreme, it seemed unrealistic. Moe scheduled a conference call with Dr. Malhan, a surgeon who did one hip and within a few days the other. Not exactly what I wanted. I had two previous surgeon, patient, experiences to compare Dr. Malhan's knowledge: questions that he answered that had been answered before and descriptive language were expertly given. Another surgeon came into view, he would not guarantee doing the hips days apart, his location in India was attractive. I realized Dr. Malhan offered the closest to what I had scheduled in the US. His manner was direct. We agreed on certain details that without the insurance mandates in America, were not necessary, perhaps harmful.
Healthbase sent forms for the medical visa, the package was quoted: 12 days in the hospital that accommodated a companion, two hip replacements or one resurfaced, the cost within $500 of each other. Physical therapy while in the hospital, transportation to and from the airport, Moe advised flight plans. It appeared that going through Paris divided up the travel best, but construction at the airport made it complicated for wheelchair requests. In hind sight, Moe's experience with travel to India made the most sense, not the travel agent I used. Also, a companion was not necessary or in my case that helpful.
Hospital staff were excellent care givers. The food provided was healthy. When I struggled with getting my appetite back after minor set backs from medication or low hemoglobin, since no transfusion was given, the dietician went out of her way to provide a helpful diet. Both surgeries, the right hip requiring over 3 hours, and the left much less complicated, were successful. Bone graft, total rebuild of the sockets, the x-rays did not prepare the surgeon for how comprehensive the osteo arthritis had been. And from November to March, when I arrived for surgery, degeneration had increased significantly. I feared, to myself, I was past the point of no return.
After 10 days at the hospital, I stayed a week in Colaaba, walking the streets, the promenade, having a physical therapist recommended by the staff at the hospital, come each morning. The swelling after surgery subsided. Before the flight I received a 24 hour blood clot injection preventative, along with directions to maintain a level of activity. The return flight was easy, safe, I did exercises throughout the flights.
My experience with Healthbase remains positive. They facilitated an international medical procedure, funds were placed with them in advance, when I needed support the response was immediate, in the future, consideration will be given to work with them. Health insurance is not a viable plan for many US citizens. Healthbase is an alternative that works.
Launa S, WA, USA, April 2011.