Charleston Bound, part 2

Fearless_One

Liz, was it ultimately covered by your insurance (since you were not local)?

AnneW

Fearless, if you're looking for SGAP, you'll need to find the surgeons who work in TEAMS. Bilateral SGAP takes two surgeons if you're going to complete it in one surgery. When I was looking two years ago, no one did SGAPs as teams except Massey with Craigie and Kline, and the NOLA guys (and probably Dr. Allen.) Things may be different now, as more have jumped on the band wagon.

Liz, CofC is a really good school, from what I hear. And what's not to love about Charleston, except maybe July and August, and hurricane season?

bennetts1

Hi Liz!  Happy anniversary!  I cannot believe it has been 1 year!  Can you remember all the discussions we had before we made our decision to go to Charleston? 

I am thrilled your son LOVES Charleston!  Hopefully, it will be top of his list for his college choice.  What is his major going to be?  Glad you all have good weather to enjoy your trip!  Did you get your visit in with Marga yet?  PM me with the details! 

Enjoy the rest of your stay in Charleston and have a drink for me tonight...I REALLY NEED ONE TODAY!!!!

Fearless_One

Anne, I think you are right about that.   I am not sure if I can't have DIEP.   The local DIEP docs said I couldn't be a B cup, but when I look at NOLA photos, some of the women look to be my size...

Del11

happy anniversary Liz!

Snobird

$25000.00 is the average cost of a new car which most people finance over 4 to 5 years. I think I would sell mine and get new breasts that will last the rest of my life even if I had to finance it.

jacee

Liz...have a great time!! I have fallen in love with Charleston. I could move there easily.

Ladies, I chose to go to Roper instead of NOLA, solely because Roper didn't require any money up front. I got everything pre approved to be paid in network with BCBS, Noone has balance billed...not Dr.Massey, Dr Craigie, Roper. I have only paid $220 total for my Stage 1 & 2. Don't sell yourself short. Take your insurance company to task and get what you want. Yes, it takes some work, but is so worth it.

Joni

Fearless_One

Snobird, if you could make the payments.   It's not so easy for everyone.    I wish it was - I would have taken 6 weeks off work, gone to NOLA and been done and never had my expanders.  

Jacee, that is fantastic!  

Diag 9/09, 1.97 cm Grade 2/stage IIA 2/16 node +/lumpectomy/chemo/rads - mammo did not detect tumor - self exam did. Hyster/Ooph 1/12/11; PBLM 4/5/11.

LindaG47

Tina,  I am so glad that you are happy with everything.  Your post made me smile.

Dr. Massey is the best and loves her mermaids! 

Liz,  I am envious that you are in CHS!  How cool that your son may be considering college in Charleston.  Also, Happy Anniversary!! Linda 

LindaG47

FL ladies,  my experience is pretty much the same as Joni's; experience and expense wise. I went to Roper because Nola was just not in my budget.  I paid nothing up-font.  I had my surgery towards the end of the year (2009), so I would have a lot of my out of pocket max, deductibles, etc. satisfied. For stage I you will have a 4 day hospital stay and about a 6 day hotel stay. Your DH can stay with you in the hospital.  You can apply to Hope Lodge, but you won't find out if they accept you until about 1 week to a few days before, so you have to have a back up. Many hotels have special medical fares and the hospital (Roper) can give you a list.  Also, many of us from this thread can fill you in too.  There are flights through the American Cancer Society and Mercy Medical that you can apply for.  They use Frequent Flier points that people donate to fly people with a medical need. You have to call the American Cancer Society and get an ID # from them.  I can't remember exactly how it all works, but then when you call Mercy Medical they will require the ID# and you to fill out some paper work.  Again, some of the ladies from this thread have done it and can give you the information.  you can also call each organization to find out how to go about it.  I think you can't apply for the flights until 3-4 weeks prior to when you need it, but it doesn't hurt to find out ahead of time how it all works.  I would like to reiterate what these other experienced graduates have already said......Don't sell yourself short.  Do your homework and don't settle for a Dr. just because they are close to where you live.   Linda

kimber3006

Hello all!  I just have a minute, but wanted to stop in and report I'm still alive and well.  As soon as I got of the heavy duty pain meds, I started trying to get caught up with home and work.  Between post-surgery care, a six year old, and all that, I haven't had much time to get on here.  Plus I've been a little emotional (can I say again that I hate what all of those drugs do to me emotionally - chemo flashbacks!) so I've been trying to distract myself as much as I could from anything "cancer" if that makes sense.  So far my new breast is still wonderful, and I'm getting about much better.  I see Dr. Marga tomorrow for my second follow up and am really hoping to get one of these hip drains out.  The other one is still going like crazy, but there is a chance I might get one out.  I'm still really swollen and new bruises are still appearing daily.  I just did my last blood thinner shot this morning (yay!) so I'm thinking the bruising may improve now.  Does all of this sound about right for 2 weeks out from DIEP?  Hope everyone is doing well.  I'll be back later....gotta run for now!

AnneW

Kimber, YAY!!! Sounds like you're right on track!! Allow the emotions--they're healthy and help you heal. I always get the weepies after surgery, and I didn't have chemo! I think it's all a little post-traumatic stress!

Anne

Fearless_One

Linda, 6 day hotel stay, that is not bad at all.   That should be doable for me - but I will be alone, so not sure if they will allow that.     Sounds like NOLA usually requires some money up front and Roper doesn't.  

Stupid implants.....I want soft, squishy foobs.....

LindaG47

Kimber, So good to hear from you and know things are going well.  I'm sure just being home with your son is good medicine.  sounds like you are right on track with everything.  Yeah, aren't the shots awful......but necessary.  Keep in touch when you can.  Stay well.

 Fearless,  You definitely can't be alone.  Don't you have a family member or friend that can go with you?  You do need to see if Roper is in net-work with your insurance.  Ashley from Dr. Massey's office can do that for you or you can check yourself.  If it is and probably will be then the anesthesiologist will be too!  You could also check Fairway near NOLA too.

jacee

Fearless- None of the Dr's at either location will allow you to leave the hospital alone. Maybe a friend or family member could come for the last half of your stay?? When you leave the hospital, you need someone to get prescriptions, and be there for anything you might need. You won't be able to drive yourself and if you fly home, will definitely need help navigating your way thru an airport and carrying your luggage. You don't want to risk doing damage after surgery. Hopefully, someone can be there for you.  Yes....soft, squishy breasts are wonderful!!!

SAMayoFL

Fearless One, if you can wait till November we can be room buddies and my husband will take care of both of us.  I have to warn you up front though that he talks a LOT!!!!!  If you just smile and nod once in a while it will be fine though.  LOL!!!!

Seriously, if you can wait till closer to the end of the year we can do it together and he really will take care of both of us. 

I have to say I just want two fairly symetrical boobs.  I don't care what they look like or feel like and I especially long for cleavage again.  Having a nice flat tummy is also a big plus for me.

GO KIMBER!!!!!  You are doing fabulous.  If I could get a written guarantee that I would be where you are after two weeks I would go through surgery tomorrow!

I know I have asked so much of you ladies already but I want to contact Dr. Massey again.  When I talked to Ashley last week she really wasn't very helpful as far as telling me about insurance.  She basically said that whatever NOLA told me would be the same for Dr. Massey.  Who would you recommend I call to talk specifically about my insurance and Dr. Massey's payment?

Susan

Journey

Ashley means well but I think she tends to protect Dr. Massey a bit more than Dr. M knows.  Just call Ashley back and tell her you really need her help.  Ask her if any of the Charleston hospitals may be a better fit with your insurance. ( I have to admit that I was so emotionally worn out that I turned all this over to my DH.  He ended up being the one working with Ashley and the hospitals about insurance.)

SAMayoFL

Thanks Journey.  Maybe I caught her at a bad time.  I will try again.

Susan

AnneW

Ashley may be swamped since Jenny's gone. I don't know if there's another care coordinater or not. Your insurance website should tell you which hospital is preferred.

I don't know that anyone can tell you what your exact out of pocket will be before you have surgery. They can tell you generally your out of network values (for example, with my insurance, in network was covered at 80%, out of network at 75%--and I had a supplement that covered the balance. As long as I'd met deductibles, I was home free. Then I met my catastrophic cap, so everything till the next year was covered 100%.May not be the same for you.)

Susan, that is really kind of you to offer up your hubby as a nurse. May as well take care of two, talker or not! What a deal!!

Fearless_One

NOLA or Charleston ladies,

What percentage out-of-pocket did you end up paying (if any)?     

Did you have to pay it up front?

I am guessing those surgeries run around 100K?

Fearless_One

Linda, no one who is not local is in network for me.   My insurance network is only in-state.   But I thought there was some provision that if there is no surgeon within 50 miles who does a certain procedure you can sometimes get it covered?

kimber3006

Fearless - Someone tried to give me a roundabout $ number for the cost before my surgery because I have never gone out of network and was really worried about the cost.  Everyone except Dr. M was in network for me.  She said insurance plans are all so different, but generally speaking, if you add your out of network out of pocket max plus your deductible, that's going to be close to your cost.  I haven't gotten my bills yet, but I'll happily let you know if that holds true.  I'm pretty sure I'm going to owe more than that, but I'm sure it will be a few more weeks before my super slow insurance company gets everything processed.  Plus I've got close to $170 in spanx at this point, and at least $100 in prescription copays that won't help my out of pocket. 

There is no way on this Earth I could have managed without help those first few days after getting out of the hospital.  I definitely could not have driven.  I just found out this morning that my family and I walked right past Tina and her husband in the lobby of Dr. M's office building and I didn't even see her!  We were both there for our 1 week post op appointments.  I was OUT of it.

Susan - Most insurance companies have online search functions to tell you if a doctor or hospital is in network.  I would still confirm later, but that might be a place to start.  Just search for hospitals in a 25 mile radius of zip code 29401.  That should cover Roper and East Cooper and all of the surgeons here.

So wish I could have caught lunch with Liz while she was in town!  I'm hoping to be cleared to drive at my appointment tomorrow, too.

Del11

Fearless: you can't get any specific answers based on another person's situation. Not trying to be mean, that's just the way it works. You have to find out your own options with your own insurance and the specific doctor you want to be your primary surgeon.  If you need help navigating that, you might want to talk to your benefits coordinator or someone at the insurance company, maybe they can give you general numbers or look up whether the doctors are in-network for you (although you should be able to do all that via a web site as well).

Fearless_One

Jeskachi, doesn't sound mean at all.    But Kimber is right - I don't think I would be able to do that alone, with the travel, etc.   I thought I could handle all this alone - I did chemo and all my other surgeries alone, but not this.    It sucks being alone.    You really do need someone.

LindaG47

Kimber,  I didn't think Dr. M was in-network with anyone!  I just thought she accepted whatever any ins. company paid her and did not balance bill.  Hummmm!  I did hear somewhere that Craigie and Klein are accepted BCBS now?  Don't know though.

SAMayoFL

Craigie and Kline are BCBS providers.  I have already had my insurance verified through them and now it shows it on their website.  When I first started looking into the surgery, it was not on the website.

Susan

jacee

Fearless-I sent you a PM.

Fearless_One

I see 3 negatives to the DIEP:

1) travel = several weeks off work + lodging $$$$$$$$$$$$$$$  (Hope Lodge may be possible)

2) Possible insurance issues = $$$$$$$$$$$$$$$$$$$  (don't know this yet)

3) Might not have enough belly for it

4) I would be alone - no one to go with me

Upside:

1) No painful expanders!    Hate these things!

1) No replacing of implants years from now

1) More natural look and feel

SAMayoFL

Fearless - for me, another plus is TUMMY TUCK!!!  I will be happy to donate some of my tummy to you if you need it!!    Plus, if we can work it out, we really can go at the same time and my husband or my Mom, whoever is with me, really will be with you too.  Now the trip home to Miami will be tough.  We can put you on the plane but getting you back off would be difficult.  Think about it!

Susan

Anonymous

Anne's right. Dr. Massey said they were a little crazy right now with Jenny gone. Ashley was so helpful and even contacted my insurance to confirm what they had told me. I was told Dr. Massey was out of network for BCBS. Maybe it was just my BCBS plan, but I could swear Ashley said she wasn't in network for any BCBS.



Another plus, whether in Charleston or NOLA, is having the top tier doctors in this kind of surgery. I know I sound like a broken record. Oh, and definitely check out the Roper/St. Francis hospital site. I got the hospital rate for all the days I had to pay. Dr. Massey provides a letter to make sure you get the rate. A good friend gave me six nights from her points, which was a huge help. We stayed at the Residence inn, which is on the other side of the Ashley River. There was a tennis event happening so a lot of places were booked by the time we looked. I recommend staying in town since it's much easier to get out and walk around. We had been before, wanted a suite, and since my friend was using her points we were sort if locked into the Marriott.