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Old 08-29-2011, 01:11 AM
JEVE19 JEVE19 is offline
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Join Date: Feb 2006
Posts: 359
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Scott,

I am in the process of switching insurance to see if I can get the ADR covered.

Don't know all of the state laws but here in Florida, we were told that we should switch to business insurance. We do own a legitimate corporation. We now have a personal policy.
As it was explained to us, if we get a business policy the insurance company can put up to an 18 month wait on pre existing conditions. But...because our personal policy has been held for 36 months with no gap in coverage, that counts towards the max 18 months. Our personal policy ends in October and the new business policy will start October 1st.
We are going to give it a try. We were told that even if ADR is not covered, the hospital part should be.
The price will go up from $549 monthly for me and the hubby to somewhere around $1,600 - $2,100 monthly.

Supposed to get final info this week.

I called my doctor's office and asked the manager what company they have the most success with as far as getting an ADR approved. We were told Cigna and Aetna.
Specifically told to ask for the Aetna POS 2 PLAN.

I will be able to post sometime in October if this worked.

I was told that BCBS only pays the doctor $2,000 for an ADR single level. They pay double that amount to them for doing a fusion. My doctor told me he has sent many papers to the insurance showing the advantages of ADR over fusion and said that it is very frustrating to him. Was told they will probably not accept BCBS in the future if this does not change.

It's all very frustrating and worse when you live with chronic pain. The insurance companies don't think that having surgery to alleviate chronic pain is necessary?

Find a doctor who will do battle with you.
Some are more willing than others.
I have to friends who have had fusions at the L5-S1 level.
One of them had hers done at TBI 14 years ago.
She is doing fine. Owns a retail wine store.
Says after standing 10-12 hours, she can still get pretty sore and tries to avoid that. She told me that she really hasn't had too much trouble with her fusion.

My other friend was a co worker who had her fusion two years ago. I asked her how she was feeling about it and her answer was "not sure". Sometimes it bothers her more than others. She has a desk job, but she swims everyday and is very active.

So, I guess there are good and bad stories about fusions and ADR'S.

Welcome to the forum. It's a great resource for info, outcomes, and other people who understand which is so important.

Thank Harrison for a lot of volunteer time and effort.
Many knowledgeable people on here and I've had nice support from several members.
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L5-S1 Lumbar M6 by Nick Boeree
10-14-2011
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