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Old 02-05-2013, 11:59 AM   #1
 
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My foot surgeon's office just called to remind me that I have an appointment tomorrow to have molds made of my feet so they can order custom orthotic inserts to help the bad foot heal and help the good foot not do the same thing.

She also informs me that she's checked with my insurance and they do not cover orthotics. Not at all. I would have to pay 1/2 tomorrow and 1/2 when I pick them up. THEY COST AROUND $400, possibly much more. I rescheduled the appointment for later in the month to stall so I can make a decision. I just missed 7 days of work due to the flu. I owe more money on medical bills than I want to think about. And that's with having always had insurance.

My only option is to charge it on a credit card and I don't want to do that because I don't see me being able to pay it off any time soon.

I am so flabbergasted and frustrated right now and I can't think straight. My mind is churning and I keep crying, manage to stop crying, and just start all over again.

I cried while I was on the phone with the woman. My left foot is still "broken" and will continue to heal over the next "several months or so" and I cannot have a cast due to my stupid eczema. Will it heal okay without custom orthotics and no cast? Will the other one be okay? Why do I have to have stupid deformed feet and eczema? I cannot afford to add one more bill to my monthly pile. I will be laid off at the end of this month, if not sooner.

I don't know if I should spend money I don't have. I know I have to take care of my health but at what point do you draw the line?

Last edited by goldencurly; 02-07-2013 at 09:11 AM.
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Old 02-05-2013, 12:05 PM   #2
 
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all i can offer is hugs and suggest you move to Canada so i can adopt you.
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Old 02-05-2013, 12:07 PM   #3
 
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That SUX! So sorry. Would she be willing to run it thru insurance anyway on the off chance that she is wrong? It will buy you some time.
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Old 02-05-2013, 12:33 PM   #4
 
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I'm sorry hon )-:

My extended health insurance doesn't cover custom orthotics either and we pay $300 a pair for my daughter. It sucks.
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Old 02-05-2013, 01:04 PM   #5
 
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When you are able, call back and find out how essential it is. If they say absolutely, tell them you need a payment plan.

I didn't do something I was supposed to when I hurt my arm, and it definitely cost much more in the long run.

I am sorry you are going through this.

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Old 02-05-2013, 01:09 PM   #6
 
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Oh, and double check with the insurance company- find out if there is some sort of alternative they will cover.

Maybe you can get them to review your case since a cast won't work out and the molds are an alternative.




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Old 02-05-2013, 01:28 PM   #7
 
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I'm really sorry. When it comes to joints, bite the bullet and pay what you have to. That stuff can escalate and effect other joints and eventually your overall health. Compensating for an injury puts more stress on other joints. I have noticed people with weight-bearing joint problems have a harder time maintaining a healthy weight because they can't get around as well. Excess weight aggravates their problems. It can be a vicious cycle.

I've never had a joint or broken bone as serious as that. But I can tell you from experience that things don't heal good as new. My childhood injuries still give me problems. If it were me, I'd do everything I could to make sure it heals properly.
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Old 02-06-2013, 01:28 AM   #8
 
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HUGS! I get so overwhelmed with medical bills and feel so guilty about them. Can you tell your dr that you simply can't afford it and ask if there are less expensive options? I googled alternatives to custom orthotics and got several hits.. dont know if there is an alternative but maybe you could show a few to your dr and he could tell you if one may help? Just an idea!
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Old 02-06-2013, 01:47 AM   #9
 
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I would call the insurance company and find out what they would cover as an alternative. Many insurance plans don't cover custom orthotics for most cases. However, there are certain times that they have to cover them (i.e, for polio survivors). Since these are medically necessary because standard treatment isn't possible, maybe there's an exception. In fact, there has to be an exception. They can't expect you to walk on an injured foot and make it worse. That's ridiculous.
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Old 02-06-2013, 04:02 AM   #10
 
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I would call the insurance company and find out what they would cover as an alternative. Many insurance plans don't cover custom orthotics for most cases. However, there are certain times that they have to cover them (i.e, for polio survivors). Since these are medically necessary because standard treatment isn't possible, maybe there's an exception. In fact, there has to be an exception. They can't expect you to walk on an injured foot and make it worse. That's ridiculous.
I called. The cast/boot combo was to stabilize my foot so I could walk on it so the medically acceptable alternative is to put me back on crutches and thus remove all weight off the foot until it heals. Walking on crutches with no weight on that foot is not an option for me. It was absolutely exhausting hauling myself around with my arm and shoulder strength. I have fibromyalgia and the physical stress of walking on crutches before Christmas set off a flare-up that I am just now starting to recover from. I talked to the surgeon and he said he will take me out of work totally and put me on "partial bedrest" combined with physical therapy to help me survive the crutches. My insurance would cover PT; of course, there is a $50 co-pay for every visit, 2-3 times a week.

If I am taken out of work for 4-6 weeks, I could be laid off immediately or worse: even fired for "excessive absenses" because since the company is no longer doing business, it is just in the process of shutting down and therefore only has 4 employees including me (and I am the only full-time employee at this point). That means the FMLA protection no longer applies.

I did think of another option. We have one of those pre-tax payroll deducted medical reimbursement plans. I need to find out if prescription orthotics qualify under it even though they don't qualify for insurance coverage. If so, I have to get the orthotics and pay for them which I will charge them on the credit card and submit an itemized bill to the reimbursement plan. When they reimburse us, I can turn around and pay off the credit card. If, if, if . . .
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Old 02-06-2013, 07:07 AM   #11
 
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(((HUGS))) I'm so sorry you are going thru all of this. I wish there was something I could do to help you out. Does your dr take care credit? It's really helped me out, especially since I don't have medical insurance. You can pay it off interest free, if paid off in time.
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Old 02-06-2013, 09:06 AM   #12
 
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(((HUGS))) I'm so sorry you are going thru all of this. I wish there was something I could do to help you out. Does your dr take care credit? It's really helped me out, especially since I don't have medical insurance. You can pay it off interest free, if paid off in time.
Yes, they do! It's the only credit card I have - I actually got it when my turtle got pneumonia last year. I paid off all of the vet bills but it has a balance on it from all the kiddos and me being sick multiple times this fall and me breaking my foot. I am paying it off with monthly payments and as is, should be able to not pay any interest or fees. I hate to add to it especially since my job is ending.

I am waiting to hear back from the medical reimbursement plan people now.
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Old 02-06-2013, 09:12 AM   #13
 
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all i can offer is hugs and suggest you move to Canada so i can adopt you.
Aw, you're so sweet! But you're way too young and hot to be my mother and grandmother to my 4 kids!

But I'll let you cyber adopt me!


cympreni - thanks for the advice about how this affects all of me! I know you are right.

My husband said to just get them AND get new (non-bright red hiking) work shoes to go with them. Yes, I look like a clown in a suit with bright red Keen hiking shoes
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Old 02-06-2013, 10:31 AM   #14
 
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...you're way too young and hot to be my mother and grandmother to my 4 kids!


lots of my friends are grandparents already!
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Old 02-06-2013, 12:35 PM   #15
 
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Tell her to run it anyway. I almost had to pay $850 for a crown because the trick didn't want to run it properly. The other receptionist ran it, sure enough they covered half the crown.

If they don't cover it, babe you may just have to pay it. You don't wanna be all crippled and in pain. (((HUGS)))


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Old 02-06-2013, 10:09 PM   #16
 
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I'm sorry that's that's their alternative. This really sucks.
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Old 02-07-2013, 05:06 AM   #17
 
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I'm sorry that's that's their alternative. This really sucks.
I think that's about what I said to the insurance customer service rep. Well that with an expletive.
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Old 02-07-2013, 09:10 AM   #18
 
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The Flexible Spending Account rep called me back and said yes, prescription orthotics qualify and all I have to do is submit an itemized bill and they will process and reimburse me in about 2 weeks. YAY!!!

While I had her on the phone I told her about my glasses that I got in August that have broken twice and that I want a new pair if for nothing else to wear when these are waiting for parts to come in. Same thing: submit an itemized bill and they will reimburse me.

It has to be a valid prescription with an itemized receipt and of course, I have to have signed up for enough $ to cover the expenses, which we have.

This means I get my orthotics!!!I have an appointment on the 20th to have molds & scans for them to be made from and I'll charge it on Care Credit until I receive my reimbursement.

It also means me and hubby both get a pair of glasses. I want a backup pair and he wants prescription sunglasses for when he is riding the motorcycle and fishing.

YAY!!!!!
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Old 02-07-2013, 09:14 AM   #19
 
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Yay!! I am so happy for you, goldencurly.

Have you looked at online glasses?
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Old 02-07-2013, 09:26 AM   #20
 
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That's great news GC!
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