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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 01-30-2014, 12:53 PM
pittpete pittpete is offline
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Default Coverage after surgery abroad?

How can i find out if Blue Cross Anthem will cover me in the case of follow up care back in the US? Xrays, MRI's, any any other therapy related issues i might need.
Can they refuse to cover me?
I really don't want to call up and ask them and alert them that i'm considering ADR in Germany.
Plus it's always a crapshoot on who you get as a rep on the phone.
You can call 3 different times,ask the same question and get 3 different answers.
Thanks
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Born 1970/1995-Hurt at work/1996-Right disc fragment L4-L5 discectomy-On/off back pain,no serious leg pain until/2007-Right herniation L5-S1,recurrent small herniation at L4-L5 with unbearable leg pain/6/08 discectomy L5-S1/leg pain relieved/occaisional mechanical pain/2012-Cymblata 60 mg,occasional aleve/2014-LB pain not debilitating but chronic,Rhizotomy relieves facet pain on right side/2015-L4-S1 facets shot/4/15 PLIF L4-S1 with facectomy
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Old 01-30-2014, 11:01 PM
bwink23 bwink23 is offline
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I have Anthem BCBS....FYI, check your insurance documents and see if you can get covered for insurance abroad. There are a couple people here who have had that covered. I would get in touch with your primary physician and see if they can order these tests for you. If not, yes you will be hard pressed to find someone to take care of you during the recovery. I would think unless something really bad happens, you would only need standard x-rays to send back to overseas doctor for review. I'm in the same process and still fuzzy on how i can handle that situation.

Then again, if something seems bad....i can't see how they can refuse you care if you're covered. Primary care physician may be able to work a referral out to a local doc willing to get you the necessary testing.
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2013 - MRI and CT scan....DDD L4-S1
left side (where my pain is) interarticularis pars fracture/defect with Spondylolithesis L5 over S1 with 2MM anterior displacement

Feb. 2014 - Hybrid lumbar fusion(l5/S1), ADR(L4/L5)...2-level cervical ADR (C5/C6, C6/C7). Dr. Pablo Clavel of Quiron Hospital in Barcelona, Spain. All M6 implants (PEEK cage and plate from Medtronic at fusion level in lumbar.) SAME DAY OPERATION for both areas of the spine.
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Old 01-31-2014, 04:56 PM
FranklySir FranklySir is offline
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Smile

Pre existing condition?? My take is can't have it both ways.

Don't see why it would not fall under that legal terminology....

I have had no problems with getting Xrays or appointments after with a surgeon for a checkup. No questions asked or denial of coverage for the tests or doc appt.
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Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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