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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
04-14-2007, 07:36 AM
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I saw another post in "Arthroplasty Central", but thought this might be a better place to pose this. Does anyone know if any insurance companies (not WC) have covered any part of a surgery in the US where there is a combination of ADR and fusion. It would seem that if insurance covers a fusion, that the company should cover at least what is "normal and customary" if you have a combo procedure. Does anyone have actual experience with this?
I am trying to get something done before I retire (in 2-3 months) because my insurance coverage will change at that point. I am even wondering about the wisdom of possibly having a fusion in the US 1st, then going to Germany for ADR on the other two levels that are problematic. What do you think. Geri
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May 2000 DDD- PhysTher & Back to work 2005- Pain returned & getting worse, Something snapped playing golf MRI/Discogram confirmed 3 level problem L2/3/4/5, Disk Bulge, facet arthrosis L4-5 Grade I Anterolisthesis, Posterior annular tear , moderate 
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#2
04-14-2007, 07:46 AM
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aetna pays
but if you are thinking on going to germany then have it all done there. if a fusion is needed. dr over there may not see it that way. you should sent your films off to Dr. Bertagnoli and Dr. Zeegers for review both of those surgeon are leaders in the field. btw welcome to the forum! chuck
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ddd 1990 2003 mri,xrays,shots,emg 2004 discogram ouch pos l4 l5 facet block neg lost all appeals BCBS 5 months of that 3 surgeons later surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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#3
04-16-2007, 03:58 PM
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I was denied a 2 level ADR, then I tried to get approved a combo 1 level fusion / 1 level ADR. They said they would approve the 1 level fusion but not the ADR and if I had the combination they wouldn't cover any of it.
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Injured 9/01 Annular tears L4/5 & L5/S1 denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5. New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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