Newbie in search of answers (Tri-Care Standard)

[Ouch!]

Hi All,

I am new here, but I have been reading this site and researching ADR for about 10 days now.

I am 57, female, with chronic back pain for about 20 years. I have degenerative disc disease, L5/S1. No accidents or serious injuries. I don't ski, though I thought about cross country skiing about 30 years ago and decided it was too cold. I can't think of any contributing factors except maybe the baby back pack I used when my daughter was a toddler. (She used to hop up and down on the brace part that sat on your lower back.) But that is all.

I have also been to Chiropractors, had PT, seen several neurosurgens, had epidurals, acupuncture, RFTC, and been on pain meds. I was on Celebrex or something similar for more than 10 years until I started having problems with it. There are other meds that seem to create more problems for me than help. I have been treated at a pain center for a bit over 18 months.

Last week I had a Discogram that was positive. I have little or no disc at the L5/S1 level. The other levels did not look bad. The neurosurgens here have only suggested fusion surgery. My pain doctor is open to what ever I am comfortable with. He is very familiar with fusion problems but doesn't know a lot about disc replacements and does not know any doctors doing replacements. He has said that he would provide any referals and pass along any information another doctor would need. BUT I have to find the doctor, hospital, etc, because he has not done a referal for a disc replacement before.

I live in Alabama, but I am not limiting myself to doctors here. I am willing to travel either in the states or to Germany.

I have Tri-Care Standard for my primary insurance. If you are not familiar with Tri-Care, it is insurance through the military. My husband is retired Air Force. TriCare doesn't pay the best and a lot of doctors will not accept it, but it is better than nothing. Both my husband and myself are self employed. Does anyone have any experience trying to get Tri-Care approval for a disc replacement?

To sum up, I need a 1 level disc replacement at L5/S1. I have to decide on a doctor, a location, type of disc replacement to get, and work on funding.

Sorry to be so long. I look forward to being part of this group. I feel like I know some of you already.

Thanks in advance for your help.

Ouch!

[Harrison]

Hey Ouch! Welcome.

I'd be interested to find out more about TriCare's policy ... I checked out the site http://www.tricare.mil/mhshome.aspx If it's comparable to military full-timers, one level (maybe even 2) may be covered.

Texas Back Institute may not be too far for you...also see Dusty's topic too for other ideas.

[NewVet]

Hi,
I know this was posted a while back, was hoping you had more information on the Tri Care stuff. I recieved a unapprove letter for my ADR from Tri Care stating the codes were wrong. I have looked every were and from what I found the codes are correct (22857&0163T). After speaking with my doctor they have had a Tricare approved ADR scheduled for this coming week.

If there is any new information anyone has found from Tri Care I could use as much help as I can.