Question by Red_Ninja: ACL surgery…I need it and have an Issue w/ Choosing Doctors. Help Please?
I was recently diagnosed with a completely torn ACL in my left knee as well as lateral meniscus damage (severity not yet known). I have 2 doctors i have already seen. Both seem fine but i am leaning towards one more than the other. The one i want to use is out of my insurance network. Based on this insurance will not cover him fully. Total cost of surgery/hospital plus doctor w/o insurance is almost 20k. The hospital he would use is on my network so insurance will pay 70% of the cost which is 11K. 30% is my responsibility=3.5k. Doc fees insurance would cover up to 50% of what they deem “fair”. His cost is 8.5K. 50% of that is bout 4K. Total for out of network cost to me would between 7.5k and 9k.
Other doc is on my insurance plan. Insurance will cover everything for him once u reach my deductible of 250, which i have met ans surpassed (at 600 now) however there is another deductible of 3600 before insurance will cover me 10% (3600 includes 250 deductible in that). So Basically will have to pay 3k for in network doc.
My question is this….Who out there patients or doctors can guide me in the right direction with doctor choice. The out of network doc is baller….he is a US olympic physician, he went to ridiculously good school for his training and japan for specialty micro surgery training. He comes highly recommended. My grandfather had surgery on his knee by him in 1990 and thought he was great.
In network doc also comes highly recommended. He is younger than the other guy but has lots of experience. Does ACL’s and meniscus repairs all the time. My Personal doc sent me to him after his doc friends told him this guy was the best around.
Both docs are highly trained and masters in orthopedic surgery with specialties in arthroscopic surgery and ACL/ meniscus are regular procedures for them.
Please help me make the decision. I am torn between docs solely based on the cost to me. My parents said they will help me pay for the surgery (im a college student-age 24).
I am very active: jiu jitsu, running, skimboarding, skateboarding, etc and i need this surgery to be a success and get me back to what i love to do w/o second guessing my choice in the future.
Help needed asap.. gotta schedule surgery for my Thanksgiving break so i don’t miss too much school!
where i wrote 10% was supposed to be 100%. Sorry
Best answer:
Answer by alianna_hodiya
first u can Private emssage me so I cna suggest antoher good knee surgeon (depending on where u live). I can try to help u there, IE you’ll have to check if ur insurance covers him, but I would go with the dr who is really good with knees, well known and good bedside manners.
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