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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 09-14-2008, 08:20 PM
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steve55 steve55 is offline
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Ive done tons of reserach and it seems that the only insurance company that is fairly consistently covering ADR(single level always, and usually double level upon appeals) is Aetna. BUT, I have been unable to clarify if Aetna will usually reimburse us for out of network doctors such as going overseas to have this done. Anyone know how likely this would be? Is reimbursement generally harder to win that preapprovals?

Its likely I will need 2 level. I am still jumping through my doctors hoops and loops of more testing before being given the final green light of ADR as a solution. Ive heard that my doctor, dr peloza is quite conservative I think regarding ADR as an option, but he does do them. I dont care what he or any doctor says, there is no way in hell I will fuse. Ive been on too many boards to see how risky fusion is compared to ADR. I can count on one hand the number opf negative ADR outcomes. Besides, cervical ADR can be reversed with fusion as a last resort in case ADR fails. This is not so much an option for lumbar patients. I know in my heart, it is the only thing that will work for me. Im in a bad way and I CANT stand the CRUNCHING and GRINDING going on in my neck. Get those suckers out!!! Ughhhhh.
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4/08- DDD at C5/6 & C6/7 & bulging discs. C5/6 portrusion.

6/08- Disco results- C6/7 painful, C5/6 popping sounds

7/08- Plasma disc decompression-significant relief obtained

11/08- pain returned to almost pre surgical levels

1/09 -Disco w/ Dr Ziglar shows C5/6 & C6/7 painful-2 level ADR recommended

2/26/09 - c4-c7 ADR Prodisc Nova with Dr Bertagnoli. 100% Success but need C6/7
ADR revision due to subsidence.
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