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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File. |
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#1
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Is anyone familiar with Optima?
I currently have Optima, but can switch to Anthem BCBS in a couple of days, although it is a bit more expensive. Does anyone know if I should switch from Optima to Anthem, considering the fact that I might entertain an overseas' 2-level ADR?
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46yo, DDD of L4-S1. Microdiscectomy L5-L4 in 2014. L4-L5-S1 M6 ADR with Dr. Clavel - June 2015. |
#2
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Make sure whatever plan you have has an "overseas rider".
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Car Accident 2002 - Small Herniated Disc C3/C4 1998 Larger Herniation and Cervical Fusion C3/C4 2005 Herniation C4/C5 - 40 epidural steroid injections from Oct 2005, - Oct, 2007 2008 - Foraminotomy at C6/C7 on left side Feb, 2010 - Cervical Fusion C4/C5 Dec, 2010 - Lumbar Fusion L3/L5 2013 - Bulge on C5/C6; herniation C6/C7 right side Mar 26, 2013 - Foraminotomy at C6/C7 on right side May 5, 2015 - ADR with Dr Blumenthal of TBI for C5/C6 using Mobi-C |
#3
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"Overseas emergency care only".
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46yo, DDD of L4-S1. Microdiscectomy L5-L4 in 2014. L4-L5-S1 M6 ADR with Dr. Clavel - June 2015. |
#4
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Anthem
Anthem did Fight me tooth and nail, but I had enough history.
They initially only paid the Hospital bill, but I gave them enough history, and they paid about 70% +/- of the Surgeons fees.(after a 4 month appeal) It is hard to trust ANY insurance. For what it is worth, I switched to Aetna, because they have a HDHP. If you decide to pay, and take this from a personal savings, like a 401, then make sure you document everything, and all transactions with dates. Try to get the reimbursement forms, in the mail as soon as you can, as soon as the surgery is over, put the forms in the mail (the doctor will have to sign them).
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Jerry, Somewhere Ohio L2-3 herniation, two days before Thanksgiving, 2012, Discectomy/Laminectomy, 3/13 Numbness in the right leg, lateral femoral, gone, July 10, 2014 L45 M6 ADR, July 15 PLIF L5-S1, Not able to access L51 Anterior. |
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