Question regarding costs/deductibles for reconstruction

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MrsGreenJeans
MrsGreenJeans Member Posts: 95
edited October 2015 in Breast Reconstruction

Hello. I have been contemplating PBMX with immediate reconstruction (most likely skin and possibly nipple saving with tissue expanders).

I have reached my deductible for this year and was hoping to have the initial surgery before year's end to save on out of pocket expenses.

Assuming all goes well and there are no complications, does anyone have a ballpark suggestion as to the costs for follow up (fills, touchup, possible nipple reconstruction, exchange)? I am thinking that I will probably reach my deductible again next year with those procedures. If that is the case then I may just not try to squeeze it in that soon. We are short handed at work and the holidays are approaching, so it may not be the best choice to do it this year.

Any thoughts from those of you who have gone through this? I'm not looking for you to share your own costs. Just an approximation of how much those extra procedures could amount to, or if you think I would definitely meet my $4000 deductible. Any input would be appreciated. I am having a tough time deciding what to do.

Thanks.

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  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited October 2015

    It's tough to say, since it seems that doctors and hospitals charge hugely varying rates for the same procedures (don't get me started!), but I can tell you that for my BMX the hospital bill that was sent to insurance was 72k. That did NOT include the doctors' bills themselves (5-7k each). My exchange surgery with fat grafting was done in an out-patient surgery center and the bill that was sent to insurance for that was 33k, again not including the doctors. I haven't had nipple reconstruction yet but I assume the amount will be similar to the exchange. If your hospitals/doctors are even in the same ballpark with their charges you would have no problem meeting your deductible. Hope this helps!

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited October 2015

    I think it is highly likely you'll meet your deductible next year especially with TEs unless you do one step with a perfect outcome and 3d tattoos as a self pay. However I had most of my 2011 costs in the last three months of the year and met my deductible for 2011 then and those costs carried over to 2012 so I didn't have to restart the deductible. Not sure if that was unique to my plan BCBS of Ok or universal.
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  • MrsGreenJeans
    MrsGreenJeans Member Posts: 95
    edited October 2015

    Holy moly, summerangel, I wasn't expecting those huge numbers!!! Yikes!

    Farmerlucy, that is interesting that your deductible didn't restart the following year. Good for you.

    Thanks for your responses, ladies. I guess I should expect to meet that deductible again either way.

    Best wishes to you.

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