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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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  #1  
Old 02-16-2012, 06:05 PM
JJames JJames is offline
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Join Date: Nov 2008
Posts: 102
Question Updated Info on Bi-Level ADR Coverage in US?

Hello all,

It has been so long since I last posted on these boards I almost feel as if I should really be posting on the New Member Introductions area! I must confess though, that I do log in and look around almost daily. I am posting now because I am beginning the steps towards finally making a surgical decision regarding my spinal situation. Previously, I was a cigarette smoker (which I am more than a little embarrased to admit here). My first step towards a surgical decision was to quit those - stopped about a month ago and intend to continue that way permanently! Main reason is so that ALL surgical options will be more available to me - bi-level ADR, Hybrid, or bi-level fusion.

My reason for posting here under the "Insurance Hell" heading is to ask if anyone knows or has heard anything regarding the U.S. FDA approving or U.S. medical insurance companies beginning to cover bi-level Lumbar ADR. Back in 2007 when I was last rejected such coverage, I was also led to believe by my surgeon, the device manufacturer, and others that this would be likely very soon -- that was about 4 and 1/2 years ago!

Just curious if anyone has heard or knows anything regarding this. I will not be revisiting surgeons and re-addressing my options, redoing MRIs, and all the other tests they will want to conduct until I have gotten way past my nicotene and smoking addiction.

Thank you all for being here on these boards and sharing your stories and advice, etc. It's meant a lot over all these years ...

Jeff
__________________
DDD diagnosed ~99
Chronic Pain since Aug 2006
Failed L4 Microdisctectomy Apr 2007
2008-Positive Disco (L4/L5&L5/S1 annular tears)
Herniated discs at L4/L5/S1, bulging T12
Began constant/severe neck & upper back pain 11/09
Jan 10-Cervical/Thoracic MRI:bone spurs+new disc probs
Cervical Spine issues causing terrible pain beginning in July 2021 - scheduled for 2 level C-Spine ADR on Oct 19th 2021 now!! Part of Clinical Trial so unsure if Mobi-C or Baguera C will be implanted ....
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Old 02-17-2012, 11:50 AM
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Harrison Harrison is offline
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Join Date: Oct 2004
Posts: 7,010
Default

Jeff, welcome back -- and congrats on kicking the habit! That's huge!

You are right, there haven't been too many changes in 4.5 years. Some people have managed to get their two levels covered -- but very, very few. I am sure others will chime in soon...
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Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
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Old 02-22-2012, 06:18 PM
JJames JJames is offline
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Join Date: Nov 2008
Posts: 102
Default Thank You

Thank you for your reply. I suppose I already "knew" the answer, but had to start by asking.

I have several other non-insurance related questions (of course), but will post those on the appropriate board(s).

Again, thank you and thank all of you here on this site.

Jeff
__________________
DDD diagnosed ~99
Chronic Pain since Aug 2006
Failed L4 Microdisctectomy Apr 2007
2008-Positive Disco (L4/L5&L5/S1 annular tears)
Herniated discs at L4/L5/S1, bulging T12
Began constant/severe neck & upper back pain 11/09
Jan 10-Cervical/Thoracic MRI:bone spurs+new disc probs
Cervical Spine issues causing terrible pain beginning in July 2021 - scheduled for 2 level C-Spine ADR on Oct 19th 2021 now!! Part of Clinical Trial so unsure if Mobi-C or Baguera C will be implanted ....
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