Saturday, July 3, 2010

First Step: Financial Interview

So, after the initial call for the transplant coordinator tell us that Gess was referred for transplant evaluation, we were contacted by the Financial Services Specialist. This appears to be the first "official" step for us. I was able to call and do this portion of the process. Basically the Financial Services Specialist contacted our insurance company to make sure that we have sufficient coverage for the lung transplant and the aftercare. The lung transplant costs $500,000 (for the lungs themselves and the actual transplantation and also for the pre- and post- hospital/tests). This is a rough estimate and can change dramatically if there are any complications or we do go the lung/liver transplant route.

This was the first time that the reality of lifetime benefit caps on insurance policies hit home. Our policy has a $2 million limit. So far, he has used $570,000. If all goes smoothly, we should be fine. But if there are complications, we could reach that amount. Plus, after a couple of years of post-transplant medications, we could certain get over that amount. Thankfully, one of the provisions of the Health Care Reform Act that goes into effect immediately (which in congressional terms means after 6 months) is the ban on lifetime benefit caps. So...we shouldn't have to worry about that at least for now, which is a big relief for me.

There are also significant prescription costs for post-transplant medications. The estimate given to me was $6000 per month for the first 3 months and then $2000 per month for the rest of his life. Our insurance will cover significant portions of this, so we shouldn't have a problem, but it is pretty daunting to think about the cost.

Also, these numbers don't include other expenses or taken into account the fact that Gess will be out of work for awhile. He's overall hope is to work as long as possible before the transplant and his employer is being really good about supporting that, then go on short-term, then long-term disability. We hope it will work out that way, but it is of course possible that it won't go as planned and he won't be able to work. So, we have to consider that and also the effect it can have on my job. SCARY!

The Financial Services Specialist sent us some forms to sign and we returned them out. So, step one is done. Apparently the Financial Services Specialist is going to notify the team that we are a "go" on the financial side. Now we wait to be contacted by the team to schedule the next step.

No comments:

Post a Comment