OP Patient Advocate (1000+ posts) Joined: Nov 2005 Posts: 1,128 | If I'd been on a HMO plan and IF I could have talked my Doc into getting the full-body scan, likely the plan would have paid for the whole thing.
I have chosen the plan I have because it gives ME the choice to go outside the PPO (preferred provider organization) if I choose and still have coverage, albeit without the in-network discounts and still having to pay the 20% (up to $2,000 out-of-pocket per year, BTW, after which the insco pays it all -- That happened in the calendar year in which I started surgery/rad -- I paid $2K and the insco paid more than $30K). I have the insurance to cover the really big stuf -- $600 isn't a trivial amount until one compares it to $30K!!
For example, if going to a CCC was NOT on the insco's list of providers or within the guidelines of local HMOs, I still had the choice to go anyway and be covered after $2K out-of-pocket -- In fact, I could exercise choice to choose among ALL the US CCCs to use the best!
Things are not always what they seem to be at first!
Age 67 1/2 Ventral Tongue SCC T2N0M0G1 10/05 Anterior Tongue SCC T2N0M0G2 6/08 Base of Tongue SCC T2N0M0G2 12/08 Three partial glossectomy (10/05,11/05,6/08), PEG, 37 XRT 66.6 Gy 1/06 Neck dissection, trach, PEG & forearm free flap (6/08) Total glossectomy, trach, PEG & thigh free flap (12/08) On August 21, 2010 at 9:20 am, Pete went off to play with the ratties in the sky.
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