Intro
 

Hi! I'm Liz. My husband is Rusty, and he's the one in pain. :(
He's been in pain for almost 5 years now, following an MVA (he was thrown out of the car during a wreck on the interstate), and was finally diagnosed Friday (19th) after about a month of severe, unbearable pain. He was seeing a chiropractor for treatment when the pain became dehibilitating. We have wondered if the chiropractor was just a coincidence. He has a ruptured disc at C 6/7. We were told the only option was fusion, and we trusted the doctor so he has a scheduled surgery for Tues. the 23rd. It really seems scary now that it has finally sunk in.
After A LOT of research this weekend, we've decided that we want to try to get approved for the Prestige disc replacement. Our only concern is we are afraid that his insurance won't cover it. We are both college students, and he is carrying Individual Blue by BCBS of Alabama. I've read in the posts that BCBS AL is covering the lumbar replacement discs on case by case basis.
We have our fingers crossed and are hoping that tomorrow we get some good news from a few doctors in Birmingham or Huntsville.
Just wanted to introduce ourselves and find out if anyone knows anything about his particular insurance. I'm really excited about the support we have found here!! :)

Liz n Rus

Merry Christmas
 

Hi Liz and Rus,

Understand you are thinking of the Prestige cervical disc for ADR. Can't help you, but have experience with ProDisc-C having had 4 discs replaced last April. ProDisc-C was approved by the FDA for one level in December 2007. I went to Germany and am trying to get Anthem BC BS to cover it, but don't think I will be successful.

If you want to check out this prosthesis you can visit Synthes Spine at http://us.synthesprodisc.com/EN-US/SurgeonInformation/ProDiscCervical/
read both the patient and surgeon sections. You can call them at the ProDisc hotline (1-800-895-7764) Monday – Friday, 9 am - 8 pm (EST) and they will give you a list of the doctors who have completed the training. Then you have to make calls to see if anyone is actually doing the surgery. They also have a section to help you get insurance coverage.

Terry has had success with Prestige, he's on vacation, but sure he will get back to you. There are other cervical Prestige ADR's here, search Prestige.

Let me know if I can answer any questions. I'm a patient, but there are many people who have been in a medical field for years, plus having ADR surgery, who can give you many different options. Good luck and take your time researching a device and a doctor. Sandy

Hang in there Rusty
 

Hello Liz and Rusty,

I notice you haven't received any feedback, so thought I would get your thread back to the top:clap:. Fellow cervies should be back home so maybe you'll get more answers soon. Let us know how things are going and what you decide to do.

It's a bummer that the FDA approves a procedure and then the insurance companies don't pay. Did you contact Synthes about ProDisc-C surgeons?
Here's to a Happy and Healthy New Year. :beer:

Sandy

Welcome!
 

Welcome Liz and Rusty! And thanks for the supportive posts Sandy!

When you can, sift through all the pertinent posts in the Insurance Hell forum. We can talk about the appeal process this week -- maybe include some other newbies in the call too.

Happy New Year, peace and better karma your way in 2009!

:angel: