Wednesday, May 12, 2010

Avoidance does wonders

I'm avoiding making a couple of phone calls these days. One could provide relief, but the also could add stress. The other will only add stress.

I need to check with our health insurer to see what it will cover for an upcoming procedure for my son JJ. He was born 7 years ago with hypoplastic left heart syndrome, a serious heart defect that means he is missing important parts of his heart. He's had four heart surgeries so far.

The docs want to do a cardiac catheterization to see how his heart is doing and measure the pressure in it. Plus they'll get a better look at two of the leaky valves.

The doc told us there could be three scenarios based on how things look:
  • We could end up leaving him alone for a while (this is what I'm hoping for)
  • He may need surgery to repair or replace those valves (yuck)
  • He may need to be listed for a heart transplant if it looks like the valves can't be repaired/replaced (double yuck!)
I started a new job last year and haven't really had to test out our new health insurer. Plus we'd always kept JJ doubled up on both my and my hubby's insurance. But since hubby's job got eliminated last year, we're back to single coverage. Worried about what will be covered and how much out of pocket will be required.

Plus, we want to take him to an out of network facility for the procedure and possible surgery. There is a hospital in network that can do the cath and surgery, but we've never used it. And they've only recently started doing pediatric caths and complex heart surgeries. Not really thrilled about being among the first here. And even if the surgeon is great, we can't bank on the rest of the staff we'll encounter being equally as great and equally as experienced in these very complex procedures.

So here I sit, avoiding making both calls. Ignorance is bliss for now. But it doesn't necessarily make the stress go away.

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