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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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Old 08-22-2011, 02:43 AM
Azhure's Avatar
Azhure Azhure is offline
Join Date: Aug 2011
Posts: 39
Angry TriCare and ADR

Okay, not sure if this has been brought up yet, but my surgeon brought up a good point...
TriCare (the military insurance), all regions, only covers ADR for those who are on active duty; they will NOT cover the surgery for those who are military dependents or retirees.
This means that entire demographics of patients are being excluded from what, clearly, the military endorses as a valid medical procedure. Spouses, children, and retirees are completely ineligible for the procedure to be covered, but active duty are covered 100%. I could understand if they denied EVERYONE, but it's only non-active duty clients that are denied.
My doctor suggested this was class-action lawsuit worthy because it is, in some form, discrimination. Anyone else feel the same? Thoughts are appreciated.
A few years back, this wasn't the case (there was no discrimination on what was covered based on your status as an active-duty member or otherwise). I guess this is the result of all those *wonderful* D.C. budget-cutting sessions.
Surgeon: Dr. Kenneth Pettine @ The Spine Institute, Loveland, Colorado
Freedom vs. ProDisc-L Trial Participant

2006: Initial disc herniation/spinal injury at L4-5, L5-S1
2007: Physical therapy and manual chiropractic rehabilitation to manageable level.
2010: Fall down flight of stairs, re-injury.
07/20/2011: L4-L5 Freedom ADR Surgery

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