Hi,
I have knee cartilage problems & would love to try PRP. However, my
insurance will not pay for such therapy & I cannot afford the
$2,500 it will likely cost me for a self-pay treatment. I imagine the
cost is an obstacle for many people with joint & tendon problems
who would like to try this. Do you have any suggestions on how I might
obtain a reduced rate from the provider? Do you have a sense of when
insurance might cover this? Thanks!
Neil
Hi Neil,
Thanks
for your questions. I know other people are in a similar situation. I
have some thoughts for you about your knee and, as a disclaimer, I make
them only to offer you another way of looking at your situation. I'm
trying to help.
I'm going to push you a little on your statement
that you can't afford the fee (and I think the cost is closer to $1000
to $1500). When it comes to healthcare, one of the first things people
often say is, "My insurance won't pay so I can't afford it." This
perspective seems independent of one's actual purchasing power. One of
the side effects of health insurance is a subconscious sense of
entitlement which is completely understandable. You've paid for
coverage and you expect to have a benefit. But, health insurance is
merely a contract that agrees to provide you specific benefits to
assist you in paying for healthcare services. It does not replace an
individual's own responsibility to take care of themselves.
Here are some things to consider to help you pay for healthcare services like a PRP injection.
- Analyze your "Latte money". My wife and I call frequent,
seemingly low cost expenditures "Latte money". It's the money you would
spend if you went to Starbucks everyday and bought a Latte for $3 or
$4. Over a month that's about $80. In one year that's nearly $1000. If
you find your "Latte money" and cut it out of your spending, you could
very likely pay for a PRP injection.
- Call the provider and ask if they have any payment plans. Most do.
- Pay your self first. Out of your paycheck, transfer a small
amount of money into a savings account. This works best if it is
transferred before you get the check. If you could save even as little
as $50/month, in ten months, you would have enough money that you could
at least get the injection and if the provider has a payment plan, pay
off the remaining balance in another ten months.
- Get a loan. While I'm not a fan of consumer debt (like
buying a 65"plasma TV and paying it off for 48 months), we're talking
about your body and your quality of life. Good health is the source of all personal freedom. It is truly priceless.
If you have to borrow the money to get healthy, it will likely be worth
every penny. Interestingly, many people will not think twice about
spending $3000 on a 65" TV but shudder at spending that same amount on
their health.
As for getting providers to reduce their fees, you certainly can
ask. Most won't reduce their fees on these types of procedures because
they take such huge reductions on the procedures that are covered by
insurance. For example, a urologist I know of recently decided to stop
performing kidney transplants and instead has decided to perform more
vasectomies. Why? He was paid $500 to perform a kidney transplant and
$1500 to perform a vasectomy. Kidney transplants are more work not only
in terms of the surgery but the follow up care and carry more risk for
both patient and surgeon. Boggles my mind. He's paid more to prevent
life from starting that to prevent a life from ending.
Insurance
comes late to the game on things like PRP. It's relatively new so until
there is enough proof that the procedure will reduce the need for more
expensive procedures and longer term care, insurance will sit on the
sidelines. I have no idea when or if any companies will cover it.
Finally,
PRP is not a panacea. You still need to go through a rehabilitative
process which, if you have not tried this already, may help you. You
may find, with the correct program, that many of your symptoms will
subside. Managing a knee problem is a lifestyle shift. You have to not
only do the right exercises, you also have to find the positions and
activities in your daily life that overload your knee and remove them
or alter them until your knee is healthy enough to tolerate those
activities.
DK
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