Ron's Posts

I live in St. Louis Missouri and I had my AVR surgery two years ago at Cleveland Clinic. My insurance, United Health covered the surgery with the applicable deductible fees. I did not think about it at the time, I registered for the surgery and insurance company gave approval two days later.

Ron, I live in Tennessee and have BCBS of Tennessee, their top tier I guess as out of the plans we were offered at work I picked the best. I went to Cleveland and had my aortic valve replaced and aortic aneurysm replaced among a few other issues that were discovered. They have paid for all of it other than my 5000 deductible. I spent 10 days at CC and 7 of them were in the ICU and have had no issues with the insurance taking care of any of it. Hope this helps

Hi Ron, I also had the same surgery as @David Augustus with Dr. Castro at Sequoia in Redwood City. They are affiliated with Cleveland Clinic. Dr. Castro is expert in valve repair and replacement, and the best doctor/surgeon I have ever met. He and his partner Dr. Harmon really care about their patients and give you the most superb personal care.

Dr. Starnes is the top option in my book. I traveled from Florida to have him operate on me. I had OHS in 1978 when I was 5 by Dr. Shumway (the father of OHS) and Starnes is his protege! So I knew I was in good hands, plus he knew what Shumway had done to me having worked along side him for so many years, it was the right fit! And the USC Keck Hospital is FLIPPING FANTASTIC!!! I was there for 8 days. Starnes has his own staff, his own rooms! The entire staff at Keck are AMAZING! And believe it or not, the food is GREAT! My surgery was just Feb 12, 2019. I HIGHLY recommend Starnes at USC Keck if you insurance covers it! I had United Healthcare and apparently, it is great insurance! Happy to help if you need anything!

Wow! Thank you everyone for the information. I will definitely consider all those options. I'd love to be able To go to Dr Castro since he is in my area. Then I could do all of my follow up with my usual insurance, which would be paid for 100%. It is scary trying to change insurance with a pre existing condition. Again, thank you all.

FYI Ron, I started with UCSF and met several surgeons. Then I consulted with Sutter Health. You can read my story or check out my review of Dr. Castro. For some reason it's hard to find information on valve surgery in the Bay Area. It was a fluke that I found Sequoia yet they specialize in valve surgery. I didn't find this site until after I made my decision, and I started with UCSF because Stanford was hard to even get an appointment with. Wherever you have your surgery, be sure to do cardiac rehab afterwards. They just opened a small facility at UCSF if Parnassus is convenient for you. Vanessa and David are awesome. I met them at Sutter/CPMC cardiac rehab. St. Mary's has one but seem only available to their patients. Just some lessons I've learned over my year of recovery.

I looked at surgeons in and out of my insurance coverage area. I was quoted $150k for mitral valve repair. If you're considering paying cash, you might want to see if there's a professional who can negotiate on your behalf. I was surprised that the cash price was higher than what these surgeons and facilities receive from insurance companies and Medicare. Good luck!

Good thinking Steve. I have insurance but it is an HMO. Kaiser Permanente. I have to stay with them due to retirement rules. I just don't feel the hospital is up to the level of experience that I'd want in a surgeon. I could get my pre and post care at Kaiser but I'd like to have my actual surgery done some place like Cleveland clinic. I'd have to travel but I think it would be ok.

Ron, I also have an HMO and was lucky enough to find an awesome in-network surgeon. I know they are not all the same but it may be worth double checking with your insurance for a full list of network doctors. They don't publicize everything/everyone on websites which I found interesting. Best wishes as you search-having confidence in your doctor and team is so important. Even though I'm anxious about the surgery, I know I have a terrific doctor and team.

Heidi, thanks for that tip. From what I've researched the San Francisco (where I live) and LA Kaiser have good surgeons the hospitals just didn't have the ratings that I'm comfortable with. I think I was reading US News and World Report ratings. I know someone from this group that had his surgery here at Kaiser and he had a good experience. But it sounds like Cleveland Clinic is the best.