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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
05-06-2014, 02:04 PM
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Seeking Humana Victims
Greeting all,
Like most of you, I'm in the midst of battling the beast, and am interested in hearing from anyone that has taken on Humana, especially if you won. I'm doing lots of research, but would appreciate any links on safety, efficacy, etc. of ADR - especially ProDisc-C and Mobi-C. There is no way in the world I'll allow them to fuse four cervical vertebrae! I may be "old" by their standards, but I'm active and have a lot to get done that requires being able to move my head. Let's take a stand for health care freedom, together! Jim
__________________
Excruciating Neck & Shoulder Pain 07/13/13 10 Months of Diagnosis and Alternative Treatment DDD C3-4-5 ADR Requested / Humana Denied Approval Working On Appeal Old Codger Still Working at Age 66 
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#2
05-07-2014, 12:10 AM
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Hi Jim!
I don't have experience with Humana but I am currently appealing an insurance denial of a two level Mobi-c. I have Aetna. I have a compiled a ton of literature, clinical studies, etc including my latest appeal paperwork direct from LDR (the producers of the mobi-c device) which has been stamped approved and signed by my surgeon and sent to Aetna as round 2 of the appeals. I'm willing to share any or all of my info. You can pm me with your email and I can send it. Welcome to the forum!! 
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2004 MRI -cervical bone spur causing pain 2011 MRI -5 bulging discs at C3-7: Recommended C5-6 and C6-7 for a two level fusion, I said no thanks. 2014 MRI -progressive compression C5-7. MRI 6/5/14- Ruptured L4-5, bulge at L2-3 and L5-S1 Dr recommends discectomy of L4-5 but won't do surgery until cervical is stable 8/2014- 8 months/3 rounds of appeals, Aetna denies 2 level cervical ADR  2 level ADR w/ mobi-c C5-7 Jan 7, 2015
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#3
05-07-2014, 10:17 PM
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Hi Jim and Kelly,
I am (not surprisingly) moving this to the proper forum -- Insurance Hell. It will remain here for one day than expire. Kelly, that's nice of you to help others. Peace, light and love back to you many times over! 
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"Harrison" - info (at) adrsupport.org 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 Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006 Creator & producer, Why Am I Still Sick? - 2012 Donate www.arthropatient.org/about/donate
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#4
06-09-2014, 02:50 PM
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Apollos,
I have Humana and was told by Texas Back Institute they are the only Insurance Co. that will not pay for ADR. I have given up on them paying for anything. I get my meds from overseas and I've found the best docs don't take insurance anyway. Don't let them give you a stroke. They won't cover rehab either.
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Bad car accident '92 Advised to fuse, I refused. 2004 Dove into pool and got some serious symptoms. MRI showed signal change in cord. Steroids cooled it down. Have been offered a fusion a dozen times. Still refuse to fuse.
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#5
06-09-2014, 06:16 PM
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Jim and Kelly
I am battling the beast, I sent in my appeal, with case studies, biomechanics articles, and still lost, it is
. Investigational' WELCOME to the ACA, this was an Analyst(an ANALYST? Yea right, what with a few weeks of "Company" training?), wait until the ACA kicks in, you will be lucky to get a Band Aid, unless you go the border and get one on the Black Market. I will talk to an ERISA lawyer, but the Insurance has most of this covered in their handbook, they know what costs money, and they will do ANYTHING to get out of paying. My insurance is pretty expensive, it would be in the neighborhood of $1000 per mo., but the Insurance SCAMS, (who are in the pockets of the politicians) are literally HELL. That said, with the approval of the Mobi-C this past August, you may have a good chance, this is an FDA approved device, for 'Two Level'. 
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Jerry, Somewhere Ohio L2-3 herniation, two days before Thanksgiving, 2012, Discectomy/Laminectomy, 3/13 Numbness in the right leg, lateral femoral, gone, July 10, 2014 L45 M6 ADR, July 15 PLIF L5-S1, Not able to access L51 Anterior.
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