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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
05-11-2006, 07:18 AM
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Here's our dilema..
We have UHC and were denied of course for ADR. We have the chance to switch to Aetna and have to decide by tomorrow to make the cutoff for June. UHC costs $735 and is a PPO Aetna costs $1,147 and is an HMO UHC has big deductibles to meet too and the Aetna would just be a 15 copay but costs alot more monthly. At least with Aetna, I'm hoping that I have a chance at being approved for the ADR, but then I guess there's no guarantee. Do you guys think we should switch? What would you do?
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L5-S1 Lumbar M6 by Nick Boeree 10-14-2011 
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#2
05-11-2006, 07:26 AM
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Not having Aetna (I have UHC), I don't follow Aetna bulletins very frequently.
That being said, I do have this this link, that you might find helpful: Aetna approval of Charite for 1 level ADR Edit: I would be concerned about switiching and Aetna not covering "pre-exisiting condtions" though...
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47 years old Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.) L4-S1: Prodisc
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#3
05-11-2006, 07:28 AM
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If you can afford it and it will not be a financial burden to you~ plus covering/offering the same options/coverage that you'd have with UHC (like formulary coverage on meds, dental, vision ~ add ons/seperate cost), then it may be beneficial.
Maybe you could call the underwriting dept. for this plan and see in detail what exclusions may be other than what is mentioned in the exclusions which at times can be a bit vague/broad.
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#4
05-11-2006, 08:29 AM
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We don't have individual insurance we have group insurance since we own a corporation.
There is no pre-exisiting if we switch...that's one good thing about Florida, it has great HIPAA laws. I can't understand why UHC won't cover it...but there is nothing I can do about it. We've already called and talked to numerous people. They still think this procedure is experimental and doesn't have a long track record yet as to it's success rate. Maybe down the road they will change their minds but for now, UHC is saying no to ADR's. Well, thanks for your opinions 
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L5-S1 Lumbar M6 by Nick Boeree 10-14-2011
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#5
05-11-2006, 09:22 AM
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SWITCH - I was in your EXACT same position... UHC denied my ADR so I switched to Aetna (open access select plan)... they approved it in ONE DAY. Aetna has a Pro ADR policy and as long as you meet the requirements it shouldn't take a long appeals process. You can always switch back to UHC during the next enrollment period after you have the surgery.
 Email me if you'd like to discuss.Good Luck and hang in there! Tricia
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Tear L5/S1 (Pain generator) IDET 2003 L5/S1 Failed Shots, MRI's, PT, Drugs & All that Jazz ADR L5/S1 May 17th 2006 w/Dr. Bitan http://adrrecovery.blogspot.com/ Doing GREAT and feeling very lucky!
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#7
05-11-2006, 03:29 PM
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Vicky,
United Health care paid for my surgery over 2 1/2 years ago through my Golden Rule MSA. If you pm me I can fill you in on how I got it done. Pat
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At 41 yr old male. L5/SI Charite III replacment 12/03,by Dr. Garcia in Miami, fl At 46 C5/C6 Prodisc C5/11, by Dr Garcia.
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