blue cross denied bi level pro disc

[rayray_1]

they have totally denied my two level pro disc with delamarter, cash price is $65,000 if everything is perfect with only two day hospital recovery time!!BX will not even pay for any of my hospital stay!

I'm considering going overseas to get prodisc, any suggestions or dr.s to refer me to would be appriciated.
thanks

Originally posted by rayray_1:
they have totally denied my two level pro disc with delamarter, cash price is $65,000 BX will not even pay for any of my hospital stay!


Rayray_1

Sorry to hear about your insurance. Mine was $70,000 for two level disc. I know it is hard to try and figure out how to do it all.

I opted not to go over seas but I am sure there are many on here who can help you.

All the best

[Don]

There aren't many folks I'd wish back problems on, but CEO's of insurance companies might make the list....

[Don]

I have been wondering if the insurance companies would pay for 1 level of fusion if I pay for the levels of ADR. I had something like that done years ago. They paid for half of everything for a neede surgery, and while I was out, I had my vasectomy reversed. Cost me about $1900, (a lot when I was making $4 an hour) but I have a lovely 10 year old daughter who is worth every penny and more. I doubt if they'd go for it now.

Good luck to you RayRay1. What state do you live in?

[Tom Panchaud]

I have been researching the Alpha Klinik in Munich, Germany - cost is around $35K plus travel expenses for a 2-level ADR, which is what I am considering. Drs. Zeegers seems very attentive to detail and is working with me to make sure the diagnosis is correct for the treatment I am expecting. Very thoroug. Check them out on-line (www.alphaklinik.com)

[Julaine]

i feel you.. dr delamarter and Kropf as well as my PM Dr davis put in a request for disc replacement surgery and as well as take out the hardward from prior fusion that is causing me excrutiating pain. Blue cross denied the removalof the hardware andmanaged care upheld the decision, then get this
dr davis put in a request for me to go through detox and they denied that as well, so it goes to show that they are being run by the pharmaceutical companies. why else would they continue to pay for my morphine percocet fentanyl cymbalta, and zanaflex. they would rather pay for me to be addicted and dependant than go to detox.
somehting needs to be done we need to take a stand

[Terry]

Julaine:

I sent you a private message to offer some assistance.

Terry Newton

[QueenB2411]

I am in the exact same situation. Blue Cross has denied my 2 level ADR as well. There are some insurance companies that will cover it though so right now I am doing my research to see about getting an individual policy with Aetna or CDPHP. Aetna coverage would cost me about $900/mo, which is a lot but in most situations cheaper than any other option.
It might be another option to research for you.

FYI I too would probably stick insurance CEOs on a back problem list as well, just so they can see how enjoyable it is.

[rayray_1]

thanks you all so much for your responses. it get's lonely being in this f****d up situation, and it helps to hear from people who can really relate. queenb, won't aetna deny you baised on a previously existing condition? tom, thanks for the overseas contact i'll use it asap. and i'll keep you posted.
thanks ray

ps and those c.e.o.s deserve to have a spinefull of herniations and ruptures!!

[Lisibug]

I checked into having Delamarter do my 3 level ADR, but the hospital costs alone were more than having the surgery done by who appeared to me to be the best ADR doc in the world - Bertagnoli, in Germany. The cost for a 3 level ADR, plus taking plate and screws out from prior fusion, was just under $47k. I think it's nearly $10k less per level required. I was extremely impressed with the care I received there - much more attentive than the U.S. hospitals and I'm happy with the results of my surgery. My insurance company wouldn't pay for anything, either. Sure hope that wherever you decide to have surgery, that you feel much, much better afterwards. By the way, if you go to GY, to your great surprise, you will be well enough afterwards to do a little sightseeing. Make sure you see Neuschwanstein, the castle the Disneyland castle was modeled after (it's located in the Alps - fantastic views everywhere). I lived in the UK for 9 years and have seen a lot of castles but this one is my favorite. Fussen, the town just before ascending to see Neuschwanstein, is gorgeous and we want to go back there with our kids and stay. Also, see the Marienplatz in Munich. There is a lovely outdoor market somewhere around there too, that is just so delightful with unusual and beautiful things for sale. Straubing is a lovely town you may stay in which is where one of his surgery locations is located and near another one. Bogen, near Straubing and where I had my surgery performed, is also a delightful little town. I couldn't believe I was able to do light sightseeing - but I could. To see the castle, I laid against my husband or the interior side of the bus to rest my neck while we were traveling. I was so surprised to be able to use this opportunity not only to get better, but also to have a great time!

[QueenB2411]

I have been told that as long as I do not have a lapse in my current insurance coverage with BCBS that Aetna and others would not look down on a preexisting condition. I am still talking with them to make sure of this cause the last thing I want is to get coverage and then discover they have a loophole around covering my condition even though I have maintained my BCBS coverage as told.
When I find out for sure I will post, but so far that is what I have heard.

I would love to travel overseas and have my ADR done in Germany. My husband used to live there and I have never traveled overseas and we never had a honeymoon, I could make it a multi-purpose trip. I do not know how anyone can afford $47k though, even if it is a lot cheaper than in the USA. We are just trying to make ends meet with three kids, one income and all my piling up medical bills, we no longer have any savings. Has anyone heard about overseas medical coverage? I read somewhere recently that some insurance companies offer overseas policies because they are realizing how much money they can save by letting people go outside the USA. Has anyone else heard about this or know any more about it?

[rayray_1]

Lisibug, how long were you in Germany? I was hoping to only go for a week at most. Also, do you have contacts to more of Dr. Bertagnoli's patients and what type of ADR was used? I'm partial to Prodisc-L.
Thanks, Ray

[Jmbeam]

Hello, Could you tell me which Blue Cross denied your two level ADR? What Surgeon and where was the procedure going to be performed? I would love to hear any experiances of anyone being able to get Insurance companies to help pay for ADR performed in Germany. THey seem to have the most experience and I have heard many good things regrading the hospitals there.

[eileen gallagher]

I had a three level prodisc lumbar L3-L4, L4-L5, L5-S1 with Dr Rudolph Bertagnoli (ProSpine, Straubing Germany) Oct 2006. Surgery was sucessful and the experience was great. I feel the med care was better there than I would have received here. Dr. B is the best at this operation. I paid around $45k for three, I was quoted about $38 for two. good luck

[LBP]

The exchange rate is pretty horrible right now so make sure your getting Euro costs for the surgery and plug it into current rates...because when some people went to Germany on this site the exchange rate was much more favorable!