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-   -   Aetna - cervical one level (https://www.adrsupport.org/forums/showthread.php?t=12955)

1Day 11-06-2014 04:46 PM

Aetna - cervical one level
 
Last year Aetna denied my 2 lumbar disc replacements as "not covered by policy" and the lawyer said since they didn't deny it as "not medically necessary" that I wouldn't win in court.

So, I was pleasantly surprised when I called them to get an update on my one level disc replacement in my neck and they said it didn't require pre-authorization, only pre-notification (coverage determination). Shocking as I needed pre-authorization for a $200 prescription but not for an expensive surgery. Getting one level done is better than none, and it is the one that is symptomatic at this time.

I'm scheduling the surgery now and once it's done, going to try to submit for lumbar again. I'm getting nervous!!!

C

Harrison 11-06-2014 10:17 PM

Congrats, Chris! Keep us posted. :wiggle:

colorado babe 11-07-2014 09:37 AM

Yes, congratulations and keep us updated. Maybe if you get the one level now you can get the second level done next year? I know Tricare started approving one-level cervical ADR's on May 1, 2014.


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