Long story short, I want to buy a mitral valve replacement for our housekeeper with my lottery winnings. Every week when I do my BoE* calculations about how the money will be spent, I budget $1M for a medical fund to handle this and a few other health-related procedures I want taken care of.
But will $1M cover it? The pre-health-insurance-discount cost of kaylasmom’s hip replacement last year was in excess of $100K…
BoE = Back of Envelope. Once I win, of course, I’ll start using EoLT (Edge of Linen Tablecloth), when I want to perform mathematical approxulations.*
** portmanteau word of my own devising, combining “approximation” and “calculation.”
Healthgrades.com puts the “list” price for a valve replacement in California as $185,000, with a typical patient responsibility of about $1,400 with insurance.
The “rack rate” for procedures is truly insane - I can’t believe they expect someone to pay that much. If those figures weren’t totally fictitious, the in-network discount wouldn’t be 90% of the cost. This kind of thing has been our experience as well (a 1-hour 40,000 surgery marked down to 4,000).
For the OP: That million would more than do it, I’d expect, especially if the housekeeper (with your help) negotiates a cash discount.
Or you could try to buy the housekeeper a health-insurance policy that gets her in-network rates. The policy would be expensive as hell, unless the state has some kind of insurance pool for that sort of thing, but it would give more flexibility for other stuff down the line.,