Before I got my heart set on Dr. Fernandez-Miranda, I needed to do some due diligence. By an amazing coincidence, I learned that my dad’s wife’s best friend’s stepdaughter had her brain tumor removed by Dr. Fernandez-Miranda a couple of months prior. We texted, then emailed, then finally talked.

“He’s a miracle worker. He saved my sight.” Shelly explained that her much larger and more complicated meningioma had already messed with her sight and sense of smell. After multiple inadequate surgeries at various hospitals and multiple other surgeons telling her they couldn’t help her anymore, she found Dr. Fernandez-Miranda. He was able to remove the tumor completely with no complications. She said he was great at explaining everything and the staff at Stanford couldn’t have been better. Within a month of her craniotomy, Shelly was back to work and able to drive again. Her vision was restored.

She talked me through some of the things to expect both in the hospital and during recovery, including encouraging me to get a “pillow system” to keep my head elevated for the first couple of months. By the end of our conversation, I knew I had made the right decision.

That out of the way, I spent the next couple of months freaking out about the money. I eventually called a financial counselor at Stanford to see if I could get an estimate. She looked through my information and said that since my in-network out-of-pocket maximum on our Cigna plan was $1,000, it should be $1,000. I said that was crazy and I was sure I was out of network. She said if that was the case, she was required to let me know that it could be up to $750,000. That made more sense to me, but it was obviously not good news. I would have to reconsider having Vandy remove Fernando if it was even one-twentieth of that.

I decided I needed a backup plan, so I went back to the web. I was just a year and a half out from Medicare, and I discovered I could get a great Medigap plan as soon as I was eligible. Then I could do the surgery in mid-2026 anywhere in the country, and it would cost $250 out of pocket. There was a risk that the tumor could start to do damage by then, but the upside was that I could still have the craniotomy at Stanford and likely have a better outcome than at Vandy. It was a solid backup plan.

Then, last month, I went back into the Stanford portal and discovered that all my appointments had been updated to say that they were in network. I was going to be charged $20 for the visit with the anesthesiologist.  

I just didn’t get it. I knew our network only covered doctors and facilities in Tennessee for all the years we’d had the insurance. I went to the Cigna portal and typed in Stanford Hospital and Dr. Fernandez-Miranda. In network. I called Cigna and talked to a human. In network. I finally read through our insurance documents and realized that when my husband retired from his city government job a couple of years ago and we switched from the city’s regular employee plan to the retiree plan, the network expanded to national. Retirees move, and the plan was set up to cover them wherever they lived.

The planets had aligned. The surgery was going to cost $1,000. Time to buy some pillows!