Health care issue - like your thoughts

[rayinpenn]

Background
1. Knees shot, tried euflexxa shots (3 rounds - one shot every 10 days each knee) 7 months ago. Not much relief but something is better than ...You know
2. Lost around 20lbs helped (20 more to go) good days, bad days (swear it is the weather) . Took kids fishing yesterday - lots of standing yet today the knees aren't bad today.. Go figure?
3. A couple of days ago Thought I'd try another round of shots .., call doctor leave message, follow up a couple days later.. Yeah we are working on it.
Thursday I get call from speciality pharmacy drugs in need of authorization to ship... I call she says cost to you is $800 - I say funny I have a $50 deductible and a 150 co-pay and I paid $200 all in last time (dr got another $500 out of me)?

It turns after 4 calls I discovered out my prescription plan CareMart made euflexxa off the approved list... So unbeknownst to me my Drs assistant found a specialty pharmacy that would bill my united healthcare (versus my prescription plan) so my $1500 dollar deductible kicked in.

I say since euflexxa wasn't wonderful can use one of the approved drugs...saving $600
You think they would have at least called me on this? I am not a big fan of people making $600 decisions for me...

These guys over billed me a couple hundred last time ...took nearly 2 months to get the money back...


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[Livefree]

I have Osteoarthritis in my right knee. Last year I got 3 shots of Orthovisc and it was like I had a new knee for almost a year. Found out this year Insurance doesn't cover it anymore.

I got 3 shots of Euflexxa this spring and wasn't much help. Been battling with the insurance since, and they will cover Synvisc One which is one shot instead of 3.

Did a little research and Orthovisc and Synvisc is made from chicken combs, Euflexxa is not, but everyone responds differently.

 

[Throwdownmyaceinthehole]

Try an Airrosti physical therapist! My knee was shot, had the treatments and I thought I was on my way to surgery, had all the X-rays, etc. A couple of visits to my Airrosti doc and some strength training and pain went away. That was 10 years ago and I'm still running. Just had the same issues with my shoulder - rotater cuff, 2 years of pain, finally went to Airrosti, three visits later, I am out of pain and back to swimming, again avoiding what I thought would only be fixed by surgery. Insurance covered the visits, no drugs, so I am a happy girl.

 

[audreyh1]

I went on an elimination diet. I've noticed that my occasional knee pain is gone - a surprising side effect. I don't need to be nearly as careful either, so I've been more active.

One of the things I cut out completely is dairy. I've since read there can be a link between dairy and joint pain.

 

[AllDone]

I've had significant, though not 100% relief with physical therapy, too. My problem is more ankle, but I have some knee arthritis also which responded much more quickly to strengthening than the ankle. As you get older, you lose muscle strength much more rapidly.

Honestly, though, I have every intention of having the darn thing replaced with titanium in a few years. Knee replacement is very routine and there's no reason to suffer.

 

[imoldernu]

Two years ago, one of my Florida friends had success with a fairly new procedure that, according to him, was successful, and resulted in a very short recovery time. Of course this is hearsay, but maybe worth a look.

Minimally-Invasive Surgery (MIS) Quadriceps-Sparing Total Knee Replacement | UW Orthopaedics and Sports Medicine, Seattle

I think it involves the insertion of a nylon or plastic slider between the articulating bones, but it may be more than that.

Thoughts on cost:

Cost of Minimally Invasive Knee Replacement Surgery

Another potential advantage is financial. A faster recovery and shorter hospital stay translate into thousands of dollars in medical bill savings compared with traditional knee replacement surgery.13 However, patients who are covered by Medicare or private insurance might see zero or only a small percentage of medical bill savings. (Also, some insurance companies may still consider minimally invasive knee replacement surgery to be "experimental" and not cover it at all. Patients are advised to check with their insurance carriers.)

In addition to medical costs, patients who work may take into account lost wages during their recovery periods. Patients who are able to return to work sooner will experience a shorter lapse in earnings.