Colorado Babe, I intend to fight! Thanks for taking the time to share your experience and give me your suggestions.
My priority right now is my health because I feel so terrible everyday. I have already resigned myself to the fact that my insurance company will most likely require me to appeal. I've researched their guidelines and while they say they will approve the ADR, in the approval process if I have had a prior surgery, they will use that to decline the request. There is no way I will have a fusion just because it's convenient for them. I would only have a fusion if my body indicated that was my only choice. I already have a surgeon in Germany that believes I need a two level ADR so physically, ADR is my best route IMO.
Of course, I will find out what the out of pocket cost is to have my U.S. surgeon do the surgery. If he convinces me that the Mobi-C is a good option for me over the M6-C then of course, I would prefer not to travel to another country to have surgery but, I have to consider all the factors. One European surgeon has implanted over 1000 and the other over 2000 so, there is that to consider too.
I will have to do the appeal after I see the U.S. surgeon in a week. But, I know that I can't wait 3 months or longer for an unexpected outcome. I'm extremely concerned about my health right now as it continues to decline. If the insurance company turns me down and turns down the appeal, I will most likely move forward with my plans to have the surgery done in Europe (assuming their cost is less than the U.S) and then fight the insurance company afterwards full knowing that they will probably use surgery in a foreign country to turn me down in future appeals. I have tried to plan out my future for all possible outcomes when it comes to this surgery. I also may speak to a lawyer if it gets too messy later in the appeal process. I just have to take this a step at a time.
I need a lot of luck and prayers right now! Thank you so much for your input. I really do appreciate hearing from people who have been through the surgery, won the insurance battle and recovered from debilitating pain! It gives me hope
__________________
2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined.
2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009.
2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures.
2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016
