In Network Provider / OON Hospital

Just wondering if I could please get some advice. I have Aetna HMO & am currently trying to get ankle surgery (ALR). The surgeon is in network with the plan and is credentialed at 2 hospitals & 3 ambulatory surgery centers none of which are in network with my insurance. I did not find this out until yesterday, after surgery was scheduled on Monday for this upcoming Monday (10/21) – so all day today I’ve been calling and getting a run around and basically this is the info I have:

Self Pay option for just the hospital portion is 12k and it must be paid in full before Monday – no payment plans are offered, only care credit and my husband and I both can’t qualify for that amount.

Self Pay for the anesthesiologist is an additional amount.

Called insurance, was told our plan has no out of network coverage so all they can do is “possibly” reimburse some later.

Tried finding another surgeon that goes to an in-network hospital… there is no other foot/ankle surgeon that does adults in the entire city. I called over 40 ortho offices on their list and none cover foot/ankle repairs. No podiatrist offices either that provide surgery.

I asked about going to a different city / out of state and was told by Aetna that only emergencies are covered out of the city I live in and this won’t qualify.

What on earth can I do?

I fell in July (7/12 actually!) and it has taken until now to get surgery – MRI shows 3 grade 3 tears on ligament’s, and then 2 grade 2 ones on 2 other ligament’s. I can’t walk without pain, my foot has a big lump on the side and if I try and walk without a brace or crutches my foot collapses. I can’t even lay on my right side (it’s my right ankle – so I can’t even drive!) it just throbs to the point where I can’t handle it for long.

See also  Travelers insurance

I am miserable and just completely devastated and feeling lost. Is there any hope here? Anything I can try?