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New Member Introductions If you just joined, please introduce yourself here. Please add a signature describing your spinal history (use the "User CP) and ask us how we can help you get started.


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  #11  
Old 03-21-2022, 07:23 PM
Brofreck Brofreck is offline
Junior Member
 
Join Date: Mar 2022
Posts: 7
Default Self pay spine surgery not with Medicare

Unless my Medicare advantage reverses denial I am only going to be able to travel for surgery. Called my surgeon's office this morning, they finally admitted they did not want to file the appeal. Sending MRI, X-ray and reports to Texas Spine, at least see if they agree with ONZ and local surgeon. Any recommendations for travel surgery? Thanks Bill
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40 year pain with numbness increasing past 20. Have seen many neurologists. neurosurgeons had many mri x-rays. Finally this January an orthopedic surgeon recommended 2 level fusion l4-5 and l5-s1. blue cross Medicare advantage denied surgery. Considering going to Germany waiting for Evaluation.
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  #12  
Old 03-22-2022, 09:05 AM
annapurna annapurna is offline
Senior Member
 
Join Date: Dec 2004
Posts: 1,648
Default

Are you requesting recommendations for who to go to for surgery or better means to travel to ONZ? Clavel and Bertagnoli come to mind as long-standing options for surgeons.
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Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
General joint hypermobility

Jim - minor C5-6 instability and facet damage, currently using regenerative medicine to address

"There are many Annapurnas in the lives of men" Maurice Herzog
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  #13  
Old 03-22-2022, 10:46 AM
phillyjoe phillyjoe is offline
Senior Member
 
Join Date: Jan 2013
Posts: 273
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Dr. Andres Schmitz, Clinic Bel Etage in Dusseldorf used by Cheryl. I can't believe that Medicare Advantage won't pay for fusion when needed. Certainly regular Medicare will pay. Unfortunately, I know that Medicare won't pay for ADR, so if my fused M6 at C6-7 needs to be replaced, it is 50k out of pocket for me, unless I want fusion. You might hire someone to fight Medicare for you if you have already fulfilled the required 6 weeks or so of PT and injections. Insurers still seem to require all those useless things before they approve surgery.
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Pre Surgery:
C3-C4:Mild disc osteophytes. Mild-moderate right facet arthrosis. Mild right foraminal stenosis.
C4-C5:Midline central disc protrusion, significant. Mild canal stenosis.
C5-C6:Moderate disc osteophytes. Mild-moderate canal stenosis. Moderate-severe bilateral foraminal stenosis.
C6-C-7:Mild-moderate disc osteophytes. Mild canal stenosis. Moderate left and moderate-severe right foraminal stenosis.
June 29,2016-3 level M6 (C4-C7) Dr. Clavel Barcelona
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  #14  
Old 03-24-2022, 06:27 PM
Brofreck Brofreck is offline
Junior Member
 
Join Date: Mar 2022
Posts: 7
Default Surgery on hold for now

Making an appointment with another local surgeon, gives me a second opinion and another chance to request surgery in US. Will be sending imaging to Texas Spine for evaluation and maybe 3rd opinion and possibly another shot at surgery stateside under Medicare. Thanks for making me feel I am not alone.

Bill
__________________
40 year pain with numbness increasing past 20. Have seen many neurologists. neurosurgeons had many mri x-rays. Finally this January an orthopedic surgeon recommended 2 level fusion l4-5 and l5-s1. blue cross Medicare advantage denied surgery. Considering going to Germany waiting for Evaluation.
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  #15  
Old 03-24-2022, 08:59 PM
phillyjoe phillyjoe is offline
Senior Member
 
Join Date: Jan 2013
Posts: 273
Default

By the way Dr Blumenthal at TBI told me (or his assistant told me) that he won't do a tele med visit for Medicare patients. So I'd have to fly across the country and bring with me MRI's that are not older than 6 months. And I should get the MRI's before I call for an appt. So if I get the MRI's and then no appt is available within 6 months, it looks like I get caught in an endless loop. Don't want to get them out there, because then if something goes wrong in getting the MRi's , then I've flown to Texas for nothing. Likely this won't happen to you, but be prepared for the medical system to fail you even if the doctor doesn't
__________________
Pre Surgery:
C3-C4:Mild disc osteophytes. Mild-moderate right facet arthrosis. Mild right foraminal stenosis.
C4-C5:Midline central disc protrusion, significant. Mild canal stenosis.
C5-C6:Moderate disc osteophytes. Mild-moderate canal stenosis. Moderate-severe bilateral foraminal stenosis.
C6-C-7:Mild-moderate disc osteophytes. Mild canal stenosis. Moderate left and moderate-severe right foraminal stenosis.
June 29,2016-3 level M6 (C4-C7) Dr. Clavel Barcelona
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  #16  
Old 03-25-2022, 12:58 PM
Brofreck Brofreck is offline
Junior Member
 
Join Date: Mar 2022
Posts: 7
Default

I will send imaging to Texas and see if they want to proceed. My MRI and X-Ray are aging out so I better get a move on. Thanks for the Medicare heads-uo.

Bill
__________________
40 year pain with numbness increasing past 20. Have seen many neurologists. neurosurgeons had many mri x-rays. Finally this January an orthopedic surgeon recommended 2 level fusion l4-5 and l5-s1. blue cross Medicare advantage denied surgery. Considering going to Germany waiting for Evaluation.
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