Surgery and Prior-existing Condition

Hello, I have a question regarding a functional surgery I would like to have performed. I have been diagnosed with having a severely deviated septum and nasal valve collapse. This negativly affects my everyday activities such as nose breathing and sleeping. A dual certified ENT/facial plastic surgeon has recommended a reconstructive septoplasty and nasal valve reconstruction.

My current insurance has approved this surgery as it is purely functional and in no way cosmetic. Both the hospital and provider are in network. I have this surgery scheduled for July 12th. My current insurance is very good, but ends on August 31st. I am not concerned about any costs while I am covered under this insurance.

However, I understand that there is a small chance of revision surgery needed after these types of procedures. I have researched my surgeon, and met with him several times for consultations and discussions regarding my questions and concerns. Both he and the facility (Cleveland Clinic) seem to be highly regarded, so I do feel comfortable with him performing high quality work.

I am wondering though, if I switch to a different insurance after August 31st, and happen to need a revision surgery, would it be covered under new insurance? I am getting married in August and will be switching to my husband's insurance. He has checked to see if the hospital and provider are in network for him. Both are. Is there any way of determining whether a revision would be covered? Again, it would only be in the instance that my breathing would become worse. Would this be considered a pre-existing condition, and therefore not covered?

I could potentially pay for cobra to continue my current insurance, but I am afraid it will be too expensive to continue, because it is so good. It would likely be more expensive than my soon to be husband's maximum out of pocket. I reached out to my current employer to see how much cobra would cost me per month, and was told I would receive a letter mid-August regarding that information. That is after my surgery date, so this is not exactly helpful news.

See also  In Network provider makes me file claims myself and over charges me…. Help?

Can anyone give me some advice here? I would really love and be so grateful to be able to breathe normally and get quality sleep. This could significantly improve my quality of life. However, the possibility of a revision and logistics surrounding this issue have me incredibly stressed and questioning whether or not I should go through with the surgery.

Any thoughts and advice are appreciated.

submitted by /u/Heidi_Trismegistus
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