Knee Injury / Health Insurance Dilemma

Discussion in 'Health and Fitness' started by AsWeCit, Dec 4, 2012.

  1. AsWeCit

    AsWeCit Junior Member

    Joined:
    Sep 15, 2012
    Messages:
    17
    Likes Received:
    0
    I am in a bit of a pickle. Hoping for any constructive advice on the matter.

    I severely injured my knee 9 months ago while living in MN. I saw a knee specialist, he said with the proper rest and physical therapy it would get better. In May my health insurance ran out and have been without in due to financial reasons. In July I relocated to West LA. Unfortunently the knee has not gotten better and needs more medical attention.

    This is clearly going to be very expensive (which is a bummer, but a reality I am facing). I am hoping for some recommendations on how best to handle seeking additional care. I know that the cheaper health care packages arent going to chime in till after $5,000 in bills, and probably wont cover a pre-existing injury. What are my options health insurance wise that could benefit me in anyway?

    Also, if I bite the bullet and pay to see a specialist without insurance, what options / clinics would you recommend seeing that wont be top dollar.



    I feel like I really only I have 3 options here.

    1. Sign up for health insurance first, just to have it for the future even though my pre existing injury will not be covered, and take on the costs of seeing a knee specialist on my own.

    2. Not sign up for health insurance, and use the money for the costs of seeing a knee specialist, even though it will add up very quickly.

    3. Sign up for health insurance and get lucky that they will cover my pre-existing injury. Does anyone have any recommendations to companies or plans that might have this loophole?

    Thanks again for helping my naive self get through this confusing / painful situation.
     
  2. highland145

    highland145 Lifer

    Joined:
    Oct 12, 2009
    Messages:
    28,966
    Likes Received:
    17
    Any insurance through your employer?

    Similar situation. Insurance but a $10K deductible.....Tweaked the knee ~9 weeks ago on the elliptical. Took it easy, seemed to be getting better, tweaked it again the Wednesday before Thanksgiving. No cardio since and it's not better.

    Since I'll have to pay, anyone know if there's a treatment to try and re grow the damaged cartilage? One with verifiable results.
     
    #2 highland145, Dec 4, 2012
    Last edited: Dec 5, 2012
  3. alkemyst

    alkemyst No Lifer

    Joined:
    Feb 13, 2001
    Messages:
    83,988
    Likes Received:
    0
    I went through a $6500 out of pocket shoulder surgery this year. My plan is cheap but high on deds.

    Both my knees hurt, and my right shoulder now (not the operated one).

    My doc thinks it's just tendonitis mostly, but is concerned with how much clicks and pops my right shoulder makes (it has since my 20's). If I make fists both my hands give off nice sounds that haven't hurt me yet ;).

    Long story short, I need three MRI's, they won't authorize them. I am getting my shoulder done though.

    Check out MRI costs in your area and find a doctor willing to work with you for cash. If you don't need contrast this should cost less than $1500. An MRI with injected contrast (a surgical procedure) is very expensive. I had to pay $2600 for my shoulder one. The first basic MRI was 100% covered. The second with contrast was the very same except for 10-15 mins of a doctor using a scope and a very long needle to shoot contrast into my shoulder.

    Without a group plan, no one will treat pre-existing. Insurance <> health care.

    If you were facing insurance running out, you really should have insisted on an MRI and resulting surgery if needed.

    Usually if you are young and a male, something like a Blue Cross/Blue Shield plan is pretty reasonable to carry. Back in the 90's it was costing me $125-175 a month. I used to carry private insurance always since when I was young most group plans would cost me more for less coverage unless heavily employer paid.
     
  4. AsWeCit

    AsWeCit Junior Member

    Joined:
    Sep 15, 2012
    Messages:
    17
    Likes Received:
    0
    Currently unemployed / college grad.

    I had the MRI done right before the coverage under my parents ran out in May.

    "Without a group plan, no one will treat pre-existing. Insurance <> health care."

    So what you are saying here is that, because of my situation, I should focus on covering the costs of seeing the specialist / treatment rather than signing up for health care that won't cover a dime of this injury?

    Thanks again to all advice anyone care share.
     
  5. alkemyst

    alkemyst No Lifer

    Joined:
    Feb 13, 2001
    Messages:
    83,988
    Likes Received:
    0
    Your best bet may be going back to college and pickup your parents plan.

    I don't know if you are beyond the 26 year old limit though (I think that is the current threshold).

    However, yes if you are limited in funds and have a major problem; focus on getting it solved rather than broad coverage that is expensive and won't cover it.

    Then look into at least a catastrophic plan which are usually cheap if you are young.
     
  6. SociallyChallenged

    Joined:
    Mar 22, 2002
    Messages:
    10,487
    Likes Received:
    0
    OP, YGPM.

    I think in CA the limit to be on your parents' insurance is 25 years old. At least, that's what I've heard from friends lately.
     
  7. AsWeCit

    AsWeCit Junior Member

    Joined:
    Sep 15, 2012
    Messages:
    17
    Likes Received:
    0
    I am 26, and my coverage under my parents expired on my birthday in May. I saw my knee specialist twice and had an MRI done right before the expiration. MRI showed nothing but symptoms of severe "runners knee".