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The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here.


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  #1  
Old 08-23-2005, 10:03 PM
sfmcfar sfmcfar is offline
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After two denials from MD-IPA (owned by UHC), the US Office of Personnel Management - the final arbiter for patients covered under Federal Employee health plans - determined that MD-IPA did not apply the guidelines correctly as to what constitutes "experimental and investigational" and must provide coverage.

So I'll probably be getting a Charite from Dr McAfee sometime in November - October is booked with family outings, and I'm hoping if I wait a little while longer, the coated endplates will be available.

What a relief.
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L5-S1 DDD and herniation
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  #2  
Old 08-23-2005, 10:20 PM
andromeda1111 andromeda1111 is offline
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Congrats...and yes smart to wait on the coated endplates. My spine problem was 11 yrs old at implantation!! Certainly you will not be waiting that long.

Laura
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March 11, 05. Successful.
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Old 08-23-2005, 11:25 PM
NCFUSED NCFUSED is offline
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Way to go Stan!!!

Best of Luck!
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John
Greensboro, NC
DDD L5-S1
Lost all ADR Appeals w/ UHC PLIF Fusion L5-S1 on 5/17/05.
Pars Defect L3-L4
DDD L3-L4 L4-L5
3 LVL Fusion Scheduled 4/08
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  #4  
Old 08-24-2005, 12:19 AM
Kim Kim is offline
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AWESOME STAN!!!! i am so proud of you! Nice to hear good news around here!
Way to go!
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Herniated disc L5/S1 2000 Discectomy 10/2003 Rhizotomy 8/2004 and 3/2005Discogram 11/04 grade 7 tear L5/S1
L4/L5 Grade 5 tear with herniation and stenosis
Evaluated by Dr Blumenthal at TBI
2/2005 ADR 2 level recommended
2 level lumbar fusion
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  #5  
Old 08-24-2005, 01:00 AM
Dale S Dale S is offline
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I'm very impressed! Congratulations. How did they not apply the guidelines correctly? Do you know the specifics of the guidelines? Perhaps the same could apply in Calif.?
Dale
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Old 08-24-2005, 12:38 PM
sfmcfar sfmcfar is offline
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In my case, there are regulations that apply to individuals that are covered under the Federal Employee Health Benefits plan, so they may not be applicable in your case. Simply put, FEHB carriers are not allowed to classify a FDA-approved device as experimental, which is exactly what MD-IPA did - twice.


Laura, do you have any info on actual vs theoretical advantages of the coated endplates?
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L5-S1 DDD and herniation
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Old 08-24-2005, 07:56 PM
Mariaa Mariaa is offline
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Stan,
congratulations!
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  #8  
Old 08-24-2005, 08:10 PM
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Harrison Harrison is offline
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Way to go, Stan! With your patience (more than Job!?) & sense of what's right for your cure, you won the right to reclaim your wellness!

BTW, not sure if the coating thing matters. You may recall all the topics on this we posted earlier. The issue of bio-reactive coatings sounds impressive (from an intellectual & marketing sense), but no one can answer the waiting game question but you. Either way, congrats -- brother Charite'!

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Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
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  #9  
Old 08-24-2005, 10:38 PM
ans ans is offline
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Fantastic news and great in setting a precedent!

Allan
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