I got a call from my doctor's office saying that my doctor, Dr. Chan (my last surgeon I went to in WA for a consult was also Asian, as well as my regular doctor here in Vacaville, and I must say I was excited that this guy in Sacramento was too because as random as this is, they have both seemed very thorough in their work...how's that for a run-on sentence?) was going to cover his part of the surgery. His assistant said Dr. Chan called Tricare and they won't cover any hip scope, and he just wanted me to have the surgery done. So all I'd have to pay for was the surgery center and anesthesiologist. I was so happy about this news, thinking that those fees couldn't be too much.
After many calls, emails, and faxes to the financial coordinator of the surgery center, it was a roller coaster of a week. I was sitting in my car in a parking lot, talking to this lady who quoted one surgery (repairing the tear) at $30,000 and shaving the bone (to make it rounder to prevent the tear from happening again) at $47,000. This is just for using the surgery room! Since the two surgeries were at the same time, they'd be combined as more of an average cost for both. Shock and then tears followed as I tried to maintain composure (more unsuccessfully than I had hoped) on the phone, devastated that this surgery wasn't going to happen, and feeling hopeless about what to do. I should have known God would work it out, but I was so upset. She called back and said that their estimate so far (but not final estimate) was $46,000 and asked if that was going to be a possibility for me. Ummmm...no. I actually don't have $46,000 laying around.
"I'm going to have to live with this for the rest of my life," I thought. Even doing a payment plan wasn't going to work on that amount of money. So finally, the final estimate for the surgery center was $35,000. She sent me a charity application to fill out to see if I qualified, so I filled it out, but I was doubtful that we would qualify. And even if we did, I didn't think they'd give us very much. I was supposed to have the surgery on a Tuesday (a few days after John was getting home), and I had to let them know if I was doing it for sure by the Friday before. After the surgery center reviewed my info, they called on Friday and told me that I would only have to pay $6,400 of the $35,000. I was beyond shocked. Why are we always shocked at miracles? And the anesthesiologist would be $700. I talked to John quickly on skype that day to talk to him about what I should do. He was tired from packing (getting ready to fly home the next day) and couldn't think about the decision enough to give me the go ahead. He said he wanted to get home and call Tricare and get some other people involved. We were told by the surgery center that we could be paid retroactively by Tricare if we got them to cover the surgery later, but John didn't think they would do that. So I told the doctor I had to wait and he reschedule my surgery for March 3rd. I was pretty disappointed, but I had to trust it was the right thing.
John got home and we've had a great time hanging out, eating at a couple of places we hadn't had in awhile, going to some of our favorite places, and just being lazy. He called Tricare who didn't give him any useful information (or the director's info) and then called Dr. Chan. I was surprised he was able to talk directly to him, but Dr. Chan's been a real peach in all this - so helpful and just wants me to get the surgery and be better. He said he was baffled that Tricare wasn't covering the surgery since all other insurances he's worked with do. He also told John that he talked to Tricare's director who said that they have denied a hundred surgeries a year and they won't change their policy unless someone makes them (ie. the government). After hearing this, we knew there was nothing we could do (at least without waiting years) to get them to cover it. It was the answer we needed to proceed with the surgery in March. We also found out that although the surgery is "too new and not proven" to be covered, it's a decade old!
I'm so glad to just have a resolution for this, even though we have to pay some. We get a 20% discount if we pay upfront, so hopefully we can do that instead of payments. AHH. Long story. The saga is pretty much over. John also talked to his boss about the surgery denial and he forwarded it on, but he didn't think anything would happen fast, if at all. John wants to write a letter to congress to have a voice in the change of Tricare's policy, and although it may take some time, I hope it makes a difference.
I heard mice all of that same week (when John was gone) after Pest Control had come, until about Thursday, and now they are all gone. My body is so much more at rest, and peace is finally in the house! Now John gets the fun job of cleaning out the garage. I really hope the mice don't come back!
Okay, onto something more fun. I found this recipe in a magazine, and it was good. And easy. Which makes it twice as good. This will be one of our regulars.
Kung Pao Chicken
2 tbsp dark sesame oil (I used regular sesame oil)
1 cup chopped onion
2 garlic cloves, minced
1 lb skinless, boneless chicken thighs, cut up into 1-inch pieces
3/4 cup water
3 tbsp lower-sodium soy sauce
2 tsp cornstarch
1 tsp brown sugar
1/2 tsp bottled minced ginger
1 to 1 1/2 tsp crushed red pepper (I did 1 tsp and it was really spicy but still good...although I only get a 2 star on Thai food)
1 cup thinly sliced red bell pepper (about 1 large pepper)
1 cup snow peas, trimmed
2 tbsp chopped unsalted, dry-roasted peanuts
1. Heat sesame oil in a large skillet over medium-high heat. Add onion to pan; saute 3 minutes or until softened. Add garlic; saute 30 seconds, stirring constantly. Add chicken; saute 3 minutes or until chicken begins to brown.
2. Combine 3/4 cup water and the next 5 ingredients (through crushed red pepper), stirring with a whisk until sugar dissolves. Add water mixture to pan; bring to a boil. Add bell pepper and snow peas to pan; cook for 2 minutes or until vegetables are crisp-tender and sauce thickens. Sprinkle with nuts. Yield: 4 servings (serving size 1 cup).



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