Confused

[Slackwater]

Originally Posted by 2Confused

Annapura,

Insurance - I wonder if that is why my Dr. says that 2 replacements cannot be done.

Insurance
Search your Insurance Company website for single vs. two-level, or any ADR/TDR :

- Coverage Position or
- Coverage Statement

and
- Artificial Disc Replacement (ADR) or
- Total Disc Replacement (TDR)

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Your current surgeon may already know your Insurance Company's "Coverage Position" on ADR/TDR in both summary & detail. I am not aware that Cervical ADR/TDR is approved for two-levels in the United States by the FDA. Two-level cervical ADR's have been in trials and there are encouraging results from my limited understanding. FDA-Bryan Cervical Disc, example.LINK

Cervical ADR/TDR is more commonly covered by insurance compared to lumbar ADR/TDR. I suggest the two (2) year Cervical ADR/TDR results are in general documented as better than the lumbar disc replacements.

The terms used by the insurance companies may/will differ. Insurance appeals are ~possible; several are ref'ed on this web site.

Agree with what others wrote.

[2Confused]

If one decides on having the surgery out of country how do we go about getting follow up care back home? Do we discuss it with our primary doctor, or do we discuss it with the Surgeon whom we originally may have been considering for surgery? I would like to have a close relationship with a doctor who will be willing to assist me post-op if I make the final decision to cross the pond for surgery.

Anyone with advise?

[jss]

For me this was a big problem. Fortunately I haven't needed any medical attention for my spine since surgery. Eighteen months after surgery I decided that I should probably have a check up. The first five ADR surgeons wouldn't see me because I went to over seas; telling me that if I wanted a check up that I'd have to go back to where I got the surgery. The sixth ADR surgeon I contacted happened to be from Germany and was happy to do my check up. My PCP that I've had for 20 years would do what he can for me if I need any attention; but he's not qualified for this area.

I don't know what to tell you to do other than keep trying local spine doctors until you find one that will agree to see you if you need treatment when you get back. A few members on the board, like me, had PCP's who were supportive of their decisions to go overseas. But I don't recall anyone with a domestically domiciled spine surgeon that was supportive of their decision to go overseas. This is not an insignificant problem.

[2Confused]

Geez, it's bad enough we are in pain - add the hassle of sealing with insurance companies and physicians who are inwilling to,see you if you have surgery elsewhere! So frustrating!!!
I can't believe how bogged down our medical system is. So many hurdles and road blocks! I feel like screaming the famous line... I'm mad as ____ & I'm not going to take it anymore!

Slack water - I think my policy will pay if, IF I jump through the right hoops and we dot the i's, cross the T's and push the right button and do it in the right order.

Another words, it's a crapshoot.