skmcphr,
Condolences on your condition, but welcome. What a discouraging story. I have two cervical fusions and two ADRs myself and can't imagine having to have had three or four fusions. While you are unable to fund the ADR from your own pocket, I still believe that you have at least two realistic funding options.
Option 1
Before filing another appeal to Cigna, I would encourage you to read
this book. The author explains how to appeal to your insurance company and win. She claims a near 100% success rate in helping others with appeals. I used her method to get my carrier to reverse its initial denial of my request for reimbursement. They've since denied on different grounds and I'm days away from sending in an appeal to that denial. The book is short, 180 pages, and easy to read. But the ensuing research on your part will take multiple weeks.
Option 2
As you are willing to travel out of country and willing to use the Prestige ADR, it may not be impossible to convince Cigna to cover an out of the country ADR. As a for profit business it should come as no surprise that they care more about profit than anything else. With some research you will be able to find ADR services in India, Thailand, Costa Rica, Mexico and other such countries in which you can receive a Prestige ADR for less than it costs for another ACDF here in the US. You will need to:
- Determine the cost of an ACDF at your local hospital (Cigna should be willing to provide this information)
- Locate foreign doctors that perform ADR for less than the price Cigna will pay for a local ACDF. I know of two web sites that you can use for this; Planet Hospital and Health Base. I used the latter and have had great success.
- Present the information to Cigna. If the cost difference is significant enough, you should even present your travel expenses as part of the cost. They may cover it.
If they agree to consider your offer, they will contact the provider with whom you've presented them and attempt to get an even better price.
The key for either of these options is that
you have to do all of the leg work and research. If you're willing to work at it, you have a chance of getting your ADR.
Good luck!
Jeff