Just returned from Germany with a new Prodisc 10 days ago

manth · #1 12-20-2007, 11:45 AM

Giddayy all

I am an Australian woman living in California. Just returned from Germany last week after having the Prodisc surgey done on L5/S1. I feel great and am no pain meds anymore. I am now 10 days post op. The reason for Germany was the surgeon was fantastic and also did 150 of these a year as oppose to 30 in a lifetime with a surgeon I had here and also the cost was $19400 euros and not $66,000 US dollars here. Now wanting to know has anyone been successful in gettin Insuarnce to pay. We were denied 3 times and am wandering if thats it for us. We are with United Healthcare. Any help or info would be much appreciated. Also if you want to know how my progress is going please fell free to ask.

38 year old woman. 2 failed disectomies in Australia and 1 successful ADR L5/S1

snapoutofit · #2 12-20-2007, 07:10 PM

Hi Manth,

You are actually ahead of me in the process but I too have United Healthcare and it was denied in both the US and Germany. I'll be going to Germany in February. The Insurance rep told my advocate (my mother) that the best we might get is 60% of one disk. I'm getting two.

Let's keep in touch. My mom is also on this sight and knows more about it than I do at this point. She's snapoutofitsmom I believe.

Glad to hear you are doing well.

manth · #3 12-20-2007, 08:14 PM

Gidday Snapoutofit.

Thanks for your response. Curious though, why wait until February??? And where in Germany are you going and what doctor do you have. I found the surgeon that I had was absolutely brilliant and also spoke English. Well I guess we will both be spending time fighting the Insurance. But I am with the help of my husabnd determined to not let it go. Good luck with the surgery. I know it has worked a treat for me so far, although I am only new still.

Kirk · #4 12-20-2007, 08:17 PM

I'll be seeing Bertagnoli in February or March. Someone who used to post here got 90% of their Germany cost covered by the exact same BC/BS plan I have, so I am hoping, but even if there is no reimbursement it will have been worth it.

luv2bfit · #5 12-21-2007, 01:08 PM

I don't have the same type of insurance that you do (I have Aetna) but I was denied 5 months before someone in the Health Care industry advised me of writing a letter to the president of Aetna personally. I easily found his information on their website and Federal Expressed it. I then followed up with numerous phone calls. 4 months later, I had a conference call with the "committee" and they immediately denied me again. The next day the President's office overturned the commitee's decision. I also was instructed to write a letter to my state's insurance board and I know that they were in contact with Aetna as well. My battle was more of using a particluar surgeon rather than the surgery itself because I have an HMO and they wanted me to stay in network.
It's worth a try. You never know!

Harrison · #6 12-21-2007, 01:17 PM

Y'all, I'll be moving this to the insurance forum soon (we call it "Insurance Hell)...

snapoutofit · #7 01-28-2008, 09:48 AM

Hi there,

Sorry I've been so lax to reply but the holidays and preparations for Germany have been keeping me busy.

Manth - We have let the ball drop on insurance - Do you have any news?

Kirk - I will be having surgery with Dr. B on February 18th. Whats your date?

I am on the verge of a nervous breakdown with anticipation.