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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 10-27-2005, 05:20 AM
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Hello everyone. I am new to this board but have found great information about ADR.

I injured my back gardening in 2002. Like always, I pushed myself even though my back was hurting. I was bending over to pick up the last bag of mulch and felt a jolt of pain in my lower back. I found out I have a bulged disc at L4/L5. The pain has gradually gotten worse since 2002 and I knew I had to do something about it in early 2005. I scheduled an appointment with a nurosurgen and he recommended spinal fusion. After doing research on people who had spinal fusion I was horrified of the outcome they had. I learned about ADR from a friend and started doing the research in July 2005. I found a great doctor doctor here in the New Orleans area who has determined I am a candidate for the ADR August, 2005. Hurricane Katrina and Rita set me back a bit but now I'm waiting on my insurace company to approve the surgery. It is late October, 2005 and I'm nervous that my health insurance company won't cover ADR. I have Humana insurace but can switch to United Health Care or Coventry HMO. Can anyone tell me if United Health Care covers this or if Humana does? I know Humana is only offered in Louisiana. I'm hoping someone can give me information on what insurance companies will approve the surgery. I don't have the money to go overseas to have this done and I don't want a spinal fusion. I'm just worried sick about this.
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  #2  
Old 10-27-2005, 03:09 PM
Juli Juli is offline
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Join Date: Apr 2005
Posts: 191
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Margaret,

If you look under the big bucket there is a lot of information about the various insurance companies. I have UHC and have not heard anyone have it approved yet but I understand insurance policies vary state to state. I had surgery last month and am waiting for them to disapprove so I can submit an appeal but am expecting to have to pay for the ADR out of pocket.
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Juli
DDD L3-L4 on down since 1990
Surgery 9/26/05 with Dr. Bitan in NYC to complete partial congenital fusion of L5-S1 and ADR at L3-L4 and L4-5.

Feeling great!
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  #3  
Old 11-08-2005, 09:31 AM
kristi kristi is offline
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Join Date: Jun 2005
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Margaret,

I would not recommend UnitedHealthcare. According to the people who have logged on to the Big Bucket, I don't know of anyone who has been approved. I've exhausted all appeals, and the Texas Back Institute has a backlog of people with UHC waiting for surgery. UHC says it is "unproven."

I hope someone comes along and proves me wrong, because I would love to hear that UHC has approved someone somewhere. As far as companies go, Aetna would be my choice if I could get it.

Kristi
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DDD for 15 years.
ADR candidate L4-L5, L5-S1
UHC insurance
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  #4  
Old 11-08-2005, 12:23 PM
Paul Paul is offline
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Ditto on what the others have said about UHC.
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  #5  
Old 11-08-2005, 02:48 PM
JeffreyD JeffreyD is offline
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Join Date: Dec 2004
Posts: 374
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Margaret,
Going oversees is not always the impossibility that it appears to be. I remember a year or so ago, I stumbled onto a guy's website who did not want anyone but Dr. Zeegers to perform his ADR, but the guy was flat broke and had few assets, plus he had a wife and 2 kids. He set up a non-profit donation site, layed out his predicament, and accepted contributions. I have no idea if he ever raised the money, but sometimes the "impossible" becomes possible. For my case it was intervention from the Lord....someday I'll get the whole story down on paper to share, like everyone close to me insists I should do.

Never give up.

God bless,
Jeff
__________________
15+ years back pain w/ advancing disc degeneration.
2002-2 level lumbar IDET w/ Nucleoplasty (very unsuccessful; huge setback)
Three level lumbar Charite (L3/4, L4/5, L5/S1) with Dr. Zeegers in Munich, Germany: 2/25/05 (successful)
Two level cervical Mobi-C (C5/6, C6/7) with Dr. Zeegers (successful)
Laser Facet Coagulation (left side: L3/4, L4/5, L5/S1 & sacral) with Prof. Dr. Reul (significant reduction in remnant lumbar & sacral pain)
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  #6  
Old 11-08-2005, 04:41 PM
sfmcfar sfmcfar is offline
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Join Date: Apr 2005
Posts: 61
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Hi,

UHC approved my upcoming one-level ADR, but only because they were forced to. MD-IPA, which is operated by UHC, had to cover mine since I'm a member of a Federal Employee health plan and they weren't allowed to classify an FDA-approved device as experimental. Didn't stop them from trying, though - they turned me down twice and finally had to appeal to the US Office of Personnel Management.
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Stan
L5-S1 DDD and herniation
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