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Old 02-11-2015, 02:14 AM
Coloradogirl Coloradogirl is offline
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Join Date: Feb 2015
Posts: 14
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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.
__________________
kate
Two-level ADR with Mobi C on 1.29.15
C5-C6
C6-C7
Lifelong runner, skier, and mountaineer, plenty of falls skiing/mountaineering
Pain started in my 20s
Dx with tendonitis in my forearms in 20s
Neck and shoulder pain worsened in late 30s
Did chiro, accupuncture, spinal injections, dry needling, medication, CBD tinctures, traditional physical therapy
When those therapies no longer helped enough, I decided to go for ADR


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