Insurance issues
Hey Ali...since your husband works for the Fed, they will cover ADR, but may only cover one level...and you'll probably have to fight with them to get them to cover that. The insurance companies that insure federal employees go by the guidelines that, if it's FDA approved, then it's not "investigational". However, the FDA has only approved a single-level disc replacement.
Here's my two-cents worth on getting around this...go to Germany. Dr. Bertagnoli's team provided me with everything I needed to give to my insurance company for a 2-level ADR, but without actually CALLING it a 2-level ADR. Plus the fact that it's about half the cost over there vs. here, so the insurance company doesn't "inspect" the foreign claims too closely...they even told me that (because they're still saving money, and they know it). I had to fight with them for a few weeks, but I won.
Plus, in my opinion, and I think a lot of people here will second this, Dr. B in one of the top spine surgeons in the world. I have a great neurosurgeon here in the States, but I'm scared to death of this surgery, and I know that my surgeon only has a few ADR procedures under his belt. That's not good enough for me...if I'm going to do this, I want the VERY BEST, because experience and track records speak volumes. So I'm leaving for Germany in 3 weeks.
If your insurance company gives you any crap, send me a private message...I'll try to help you.
Jess
__________________
36 year old mom of 7 in SC.
MRI 4/2008 shows bulging disc with annular tear @ 4/L5 and and complete herniation at L5/S1.
9/11/08 Laminectomy , successful to a point...relieved nerve pain, but after 4 months was still having severe disc pain.
Treatments tried: epidural shots, oral pain killers, NSAID's, TENS massage, chiropractic care, deep tissue massage. Oh, and plenty of our homemade wine! 
May 26 2009, 2 level ADR, L4-S1, Dr. Bertagnoli, Straubing, Germany
Last edited by jessmith07; 05-05-2009 at 06:27 AM.
|