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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
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Am I the only one who's on Medicare because they're disabled? (or over the hill?) I have heard/read about all these insurance hassles and a few successes, but no one seems to mention Medicare as their carrier for ADR reimbursement.
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#2
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I am on workers' compensation because my back injury occured at a crisis response training session in front of about 25 witnesses. I haven't seen or heard much from individuals with medicare on this site or in the community. According to my surgeon and underwriting insurance company, many people covered by medicare do not qualify for ADR because of their age. Even I had to appeal my case to the state board to have ADR rather than fusion, and I was 34 at the time of my injury. If I receive any updated information this week, I will keep you in mind.
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Crystal L5/SI Charite 7/18/05 Dr. Howard http://www.myspace.com/luvmysibe http://www.xanga.com/luvmysibe "A smile is contagious, be a carrier ." |
#3
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Does denial of add-on payments mean that Medicare is not necessarily denying coverage for ADR surgery but it is not fully covering all the costs?
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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 |
#4
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CQ,
Medicare is my medical provider tho WC covers my low back with lifetime future medical~ in fact, had to sign a Medicare Waiver on that area b/c of WC coverage.. |
#5
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I also wonder if I could circumvent their denial by having a combination fusion at two levels and ADR at one level. My figuring goes that for the fusion alone many things such as hospital stay, anesthesiologist, etc would be covered. Or is it all or nothing at all..Is'nt that a Cole Porter number?
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#6
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I have confirmation that non-payment of add-on means that Medicare will not pay for the device itself but will pay for surgery, hospital, etc.
The article that Amy references has an e-mail address for the public to express concerns. Since, as the article indicates, Medicare's decisions ultimately determine private insurances' decisions, it is really important for those who have had ADR to speak up.
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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 |
#7
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If you have had bone morphogenic protein in a fusion or have had other procedures, you need to speak up as presently, Medicare is not covering ANY of these procedures. Now the hospitals are refusing to see medicare spinal patients (Me, being one of them).
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#8
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Hi Amy.
I agree w/Deyo in regards to the Europeans not providing good data after many years. Also, the risks of migration/subsidence can be serious w/salvage not being an option (yet fusion offers no option). However, I respect your acuity in recognizing the sweeping importance of this one decision. - Allan
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand. |
#9
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I think the Europeans have showed lots of data not only now but in the past.
Many people have not accepted their data and many have not asked for their data -- -I think that is the "Rub"!!! The answer people get depends on the question they ask Best Alastair
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ADR Munich 26th July 2002 L5/S1. Aged 82 now Your best asset is your health My story is here http://www.adrsupport.org/alastair.html Thank goodness for Dr Zeegers I am painfree I am here to help,I live in the UK I now run the UK spine site and can be contacted at www.adrsupportuk.com/ |
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