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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 04-24-2009, 01:54 PM
symara symara is offline
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Join Date: Apr 2009
Posts: 34
Default so what would insurance cover????

sorry if this has been asked, but I did a search and had trouble finding answers.

Of those of you that have had ADR and the insurance didn't pay for it...

What will the insurance now covere? Will they cover complications or if you need removal and fusion now?

Also, if you are involved in a trial, who covers any complications? I'm trying to see if I might be able to get involved in a clinical trial.
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Herniated L4/L5 May 2004 (Bed ridden)
Discsectemy June L4/L5 2004
Discssectemy L4/L5 January 2007
MRI May 5th - showed "moderate sizd protruding disk in the the left paracentral location at the L4-5 level which appears to a more porminent comparison to the prior examination" and "appears to impinge upon the exiting nerve root"
May 11th Dr Apptment - Told that another Discsectemy could be done.

Looking for Surgeon for second Opinion
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Old 04-24-2009, 06:41 PM
sahuaro sahuaro is offline
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Join Date: May 2005
Posts: 455
Default

I can only answer your first question: HealthNet covered nothing related to the surgery. They did pay for follow-up visits with the surgeon and subsequent X-rays.
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2001 MVA; C5-C6 disk extruded
ongoing physical therapy, exercise and massage
ESI's, oral prednisone, trigger point injections
foraminal and central stenosis C5/C6 and c6/C7
2007 EMG/nerve conduction shows pattern of chronic radiculopathy
January, 2008: Prestige ST Artificial Disk Replacement, C5/6
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