After two denials from MD-IPA (owned by UHC), the US Office of Personnel Management - the final arbiter for patients covered under Federal Employee health plans - determined that MD-IPA did not apply the guidelines correctly as to what constitutes "experimental and investigational" and must provide coverage.

So I'll probably be getting a Charite from Dr McAfee sometime in November - October is booked with family outings, and I'm hoping if I wait a little while longer, the coated endplates will be available.

What a relief.

Congrats...and yes smart to wait on the coated endplates. My spine problem was 11 yrs old at implantation!! Certainly you will not be waiting that long.

Laura

Way to go Stan!!!

Best of Luck!

AWESOME STAN!!!! i am so proud of you! Nice to hear good news around here!
Way to go!

I'm very impressed! Congratulations. How did they not apply the guidelines correctly? Do you know the specifics of the guidelines? Perhaps the same could apply in Calif.?
Dale

In my case, there are regulations that apply to individuals that are covered under the Federal Employee Health Benefits plan, so they may not be applicable in your case. Simply put, FEHB carriers are not allowed to classify a FDA-approved device as experimental, which is exactly what MD-IPA did - twice.


Laura, do you have any info on actual vs theoretical advantages of the coated endplates?

Stan,
congratulations!

Way to go, Stan! With your patience (more than Job!?) & sense of what's right for your cure, you won the right to reclaim your wellness!

BTW, not sure if the coating thing matters. You may recall all the topics on this we posted earlier. The issue of bio-reactive coatings sounds impressive (from an intellectual & marketing sense), but no one can answer the waiting game question but you. Either way, congrats -- brother Charite'!

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Fantastic news and great in setting a precedent!

Allan