Well it has been a month and a week since Zanes Heart operation and we can certainly notice the difference! Zane is more energetic, more active, does not lose his breath like he did before and best of all he has no longer got that blue tinge to his skin and nails. We are SO happy. I feel a little guilty about dissing the Surgeon, Kinsley, but I must say he did do a good job and we are very happy with his work and even more importantly we are happy that Discovery covered HIS bill in full. The anesthetist on the other hand, Discovery skimped or he over billed by about R1700. Ok ok let me break it down for any one who knows their kid is having an operation let me give you the financials for a typical infant Heart operation So far. I will update, but lets check it out.
Zane stayed in the hospital for 10 Days. 5 Days in ICU and 5 Days in High care. In ICU there is a dedicated nurse on duty the entire time monitoring him and making sure all is well. They take shifts and they do an awesome job. Then in High care they have a Ward or their own room (*grin*) But only a few nurses cover the entire floor and they do rounds. Lucky for Zane We never left his side here.
So Sunning hill Nursing home for 10 days, R110 000 and if you are on Discovery even a hospital plan or up, they will cover ALL of this.
Kinsley’s (Surgeon) bill for the operation and checking up on him before and after came to R24000. Remember Discovery has a Medical aid rate which is a middle to lower plan and then there is a %300 above medical aid rate.(luckily I opted for this).
So Discovery covered the R24k. There are 3 other bills for this operation. The Anesthetist who is way over 300% of Discovery rates. and the Perfusionist who handles the heart and lung machine and the Paediatric Cardiologist.(Dr Dansky)
Dansky’s bills are all covered b Discovery, in fact I have never seen a bill from him.
The Anesthetist (Dr Els) well I will make a call to the accountant and insist that I only can afford Medical aid rates. As for the Perfusionsist I have no idea who this person was how much they charge and where they are. I have not even seen a bill and its been over a month since the operations. I have checked Discovery with no luck.
So normally during the year and during my self payment gap I bitch at Discovery for their pettiness and inability to care for their members. However, as for last year I think I we came out tops, and are happy Discovery covered all the bills that were necessary to pay. I think with my Diabetes chronic medication and Zane’s 30k a shot Health injection, the Twin birth, The Heart operation, all the doctor and dentist visits, Philippa’s pill I think I may have cost Discovery around R300k. The monthly contribution to Discovery for a family of 4 is roughly R3700 which works out to around R44000 per anum. Just that alone is well worth a medical aid, if only they were not so anal about payments and just cover everything.
Ok enough ranting about medical, but it is good news for parents who need to have an infant heart surgery. R160k – 200k if you have no cover. R2000 +- if you do.