“…I'm also wondering what Anthem's deal really is? If ADR is cheaper, or at least not significantly more expensive typically, the recovery is quicker, the risk of additional issues decreased etc etc why would Anthem not allow ADR? If they only care about the money, as we know they do, then why not allow ADR? It would make more sense if the ADR cost significantly more. And why would others (Aetna, Cigna, some BCBS) who are also only calculating the dollars have figured it differently?”
Well stated indeed. I’ve been wondering the same thing since disc replacement trials started in the U.S.
eleven years ago! In case you didn't see my presentation on the results of my survey of this community's outcomes, see this
presentation to the SAS on this rigorous analysis.
There are many reasons why different insurance companies have their own policies, but most of it has to do with their own organization culture and resources. Some companies “get it” and have better number crunchers and better data.
Still other companies have arguably more resources, and reach different conclusions and draft different policies
based on their understanding of spinal diseases and their multiple etiologies. And they do not cover ADR or other new non-spinal treatments. But they don’t share this information with us and they never will – they have no reason to do so – like any other insurer.
I produced a DVD that deals with many of the issues in your post. Did you watch it yet? It may help you with some of these annoying problems. See the non-profit site and
video here.
Question: Is your degenerative spinal disease localized to one level?