brief introduction/scheduled for 2 level mobi-c
 

Hello,
My name is Michael Bussink. Grateful i found this place! I am scheduled for a c5-6 , c6-7 mobi-c cervical disc replacement surgery on February 24th. I was originally scheduled for a fusion on February 9th but researched and found out about the mobi-c. Thanks to my dr who did my l4-s1 fusion for using the mobi-c and the grace of god i was able to cancel the fusion surgery and schedule the two level adr within a work week. Now I am sweeting because I have anthem bcbs insurance. I am working on a equity line of credit to have funds ready in case they dont cooperate. I figure I can fight with them later if they dont aporove at first. The hospital wants a large chunk of money up front. I cant wait any longer for surgery; I need to get back to work and be sane again.

Michael,

Best of luck, both on the surgery and getting insurance to cover it. Where are you located? I'm interested in all ADR surgeons in the U.S. who use Mobi C. Btw, in the worst case scenario, you can deduct unreimbursed medical expenses to the extent they exceed 10% of your adjusted gross income. Hopefully that won't be an issue though. As a CPA I can give you more details if that becomes one.

Best of luck!!

Gene

Best of luck. I had the mobi-C surgery on my C5-7 on Oct 20, 2014. After 3 appeals I won through my insurance. The whole procedure cost me $25.00. If insurance denies you, keep fighting.

Gene,
I live in edgewater, Maryland (very close to annapolis). I will have the surgery in Baltimore at mercy medical center. Can I write off paid interest on a home equity line of credit?



Colorado babe,
Good to hear you won! I will not give up if they dont approve.

Mike,

Yes, you can deduct 100% of interest on a home equity line of credit. If this is to pay for your medical expenses, you can write off those as well to the extent they exceed 10% of your adjusted gross income.

Let's hope that insurance pays for it. Better to have it covered than paying for it and deducting it.

Best regards,
Gene

Hi Michael - I just went through the same type of thing....was going to get the two level fusion but something inside me told me not to do it. I then researched online and found this board and others and learned about two-level disc replacements. I then scheduled the surgery with my surgeon who said insurance is crazy to deny a two-level when the outcomes are superior and less expensive than a two-level fusion. So I called Anthem BCBS and even recorded the phone call. The customer service person said if my surgery was medically necessary a two-level adr would be covered. Great, I thought. I had every single box checked in the surgically necessary list according to my surgeon and I had none of the conditions that make a two-level adr not a good option. Well guess what....Two weeks before my surgery they deny my coverage and say that two-level adr is considered investigational/experimental. I was pissed and in so much pain! I had heard United covered two-level adrs and even found their policy on them online. I threw caution to the wind and switched my family from the relatively affordable Anthem policy we had (500 bucks a month for a family of four with like a 12k deductible...which I went through entirely last year due to this pain with injections, physical therapy, MRIs, rxs etc..so combined with premiums and out of pocket that cheap policy still had us spending 18k in one year for our healthcare for four people.) to United's platimum policy for my family of four. We pay the ridiculous amount 1900 a month for the four of us but there is just a tiny deductible. We just know we will spend about 23k for this year and it will cover not only this whole surgery but every last doctor visit, pt visit, healthcare need we have for the rest of the year. I couldn't handle the pain any longer so we decided to switch. United approved the surgery 10 days later (3 days before my surgery date). It was so stressful but I am glad we made the decision we made. No extra spending money for us this year...but we will all be in good health and we can go back to a cheaper policy next year. good luck! So far United has been a dream to work with compared to Anthem. But don't give up on Anthem. Maybe just also call and apply for United and get approved just to have it in your back pocket in case you need to switch last minute. You are in a different state than I am and they probably have different rulings on what is allowed and what is not allowed. New laws are they cannot discriminate and deny you with a preexisting condition so long as there is NO LAPSE in your health insurance. This means don't cancel Anthem until you are solid and accepted by United if that is the route you go. Anthem would then refund you the portion of the month that you did not use them for insurance.

It looks like im all set with funds in case the insurance company doesn't approve right away. I was approved for a home equity line of credit, but it takes about 30 days to go through. I have enough credit available on two credit cards to pay the hospital up front. Then of course pay off the credit card bill asap with the equity line as soon as it is available and fight the insurance company for coverage. Hope this doesn't happen but at least I have a plan and dont have to worry about not getting my surgery done on the 24th. :sleeping:

Michael,

You will be so happy with this decision! I'm 5 weeks out from my 2 level mobi-c surgery and I feel like a completely different person. I started my insurance process with Aetna in Jan 2014, and fought them all year to no avail. It was hard doing all the paperwork for appeals while in so much pain. My hope for you is that they cover it right away, but be warned they most likely will not. So, have your surgery, recovery should be a snap, then you can roll up your sleeves and go the rounds with bcbs. If we all fight, regardless of the little battles lost, we can drive ADR in the right direction. There are plenty of people on the forum that can help you with appeals, and since you are going with mobi-c, the manufacturer, LDR had a consulting firm handle the bulk of my paperwork.

Best to you and I hope this helps.

Michael,

Good luck with insurance, getting them to pre-approve, home equity, etc... But most of all, good luck on the 24th! It's a cool sensation to feel better, even with the pain of surgery, when you wake up in recovery than you did when they put you out. Good luck!

I spoke with anthem bcbs today about pre-cert for my surgery and they of course didn't approve my two level disc replacement. But my surgeon is set to talk to the anthem doctor to do a peer review and explain to them why the procedure isnt experimental and why it is the best option for me. The nurse that i spoke with today is handing my case at anthem and was very nice and explaied everything well. She will be calling me as soon as a decision is made after the peer review. My doctor is supposed to talk with anthem on Wednesday 18th or Friday 20th. My surgery is on tuesday 24th. I am staying positive in hopes for approval:jacks:; I have faith in my doctor talking to anthem. But i am preperaed for whatever the outcome is. Either way I will be under the knife on the 24th. Feels like an eternity waiting for this surgery.:Dead: