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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 06-15-2010, 01:39 AM
Frankg Frankg is offline
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Default Strategy, tips, new rules, etc. for switching provider

OK, so it seems that alas we are seeing actual coverage of ADR and formal changes in coverage policies from a few companies like Aetna and BC. But insurance companies and policies vary greatly. Given the insane number of insurance companies and the state-by-state nature of each company's policies, coverage of ADR will not be universal any time soon.

Those of us that are stuck with insurance companies like United Healthcare that do not cover ADR need a way out. I realize that the provision in the new healtchare bill prohibiting companies from denying someone a policy or coverage of a procedure due to preexisting condition doesn't take effect until 2014. But that's about the extent of my knowledge.

Can anyone with a better understanding of this market tell me if there is a way for someone like me that has a major paper trail of preexisting DDD to purchase an individual policy that does cover ADR from Aetna or another company then turn around and have the surgery?
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Old 06-16-2010, 09:43 AM
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Harrison Harrison is offline
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Frank, have you already tried to buy Aetna?
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Old 06-16-2010, 10:17 PM
Frankg Frankg is offline
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Actually NO. That's a very good question. I'm assuming that either they will tell me before I buy that the procedure will not me covered or after I buy and try to bill for adr surgery they'll say i had the condition prior to them issuing the policy. Is this a reasonable assumption?
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