Medicaid & out of state specialist surgery?
I am 27 years old and located in Massachusetts. I fell 20-25 feet onto hard winter ground out of a broken window in my attic and fractured multiple levels in my back and sustained a serious intertrochanteric fracture to my hip while dissociating on a newly prescribed psychiatric drug I was allergic to. I received prompt surgical intervention for the broken hip but the surgery was botched and I am now afflicted with a significant malrotation and limb length discrepancy that substantially impacts my ability to walk balanced, or even sit down for long periods without pain. Intertrochanteric fractures have high incidences of botched operations due to the complexity of the fracture and rotation involved. There is an experienced limb malrotation specialist located a state over from us in New York but my insurance (Medicaid/MassHealth) won't necessarily cover an out of state specialist and the cost of the surgery (hospital fees & surgeon included) is 100,000 dollars. We went to see an in-network orthopedic surgeon for a second opinion but he did not assess my limb lengths or the rotation of the limb (which is what's disabling because it throws off my balance and literally causes my right knee to knock against the inside of my left), he simply assessed the stability of the implant itself, which isn't the issue. I was wondering if it were possible to get MassHealth to cover an out of state specialist to perform the surgery if the specialist could provide adequate evidence to reinforce that the initial surgical outcome left much to be desired and would require correction? I completely understand if my case is too complex to provide an opinion on.
submitted by /u/Bumblefugg
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