Harrison and LBP, you both alluded to two of the major problems/discrepancies in how the majority of us receive health insurance.
LBP mentioned "Basically, If any drug, medical device, or biological product is FDA approved it can no longer be deemed "investigational" and/or "experimental" and should (must) be covered by one's health insurance plan if (1) it is being used for it's intended purpose and (2) it is deemed medically necessary and appropriate for the patient as determined by their treating medical professionals."
They key here is that insurance agencies are given the ability to determine what is and what isn't medically necessary. That's the loophole right there! What gives them this ability to determine an ailing patient's fate? ERISA!
Harrison noted that "federal employees get preferential treatment." The reason for this is because Federal employees that receive their health insurance from the Federal agency they work for are not covered under the laws of ERISA. As a result, these insurance agencies MUST cover all FDA-approved devices and drugs.
Let's not also forget... Artificial Disc Replacement surgery is not the only device that faces these problems. MANY devices are not covered by employer-based health insurance agencies.
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