This is a discussion on Aetna - anyone had out of country ADR or fusion covered??? pay now or appeal forever? within the Health Insurance forums, part of the Insurance and Travel Forums category; I have a very strange allergy history - very afraid to get a prodisc for this reason and the ADR ...
I have a very strange allergy history - very afraid to get a prodisc for this reason and the ADR guy where I'm moving seemed reluctant to put one in me. he started talking about osteolysis and the mess that can happen if one becomes allergic to CrCo alloy. 3 other surgeons have specifically said NOT to get a US ADR and to have ALIF or MIS TLIF.
Problem is... I have Aetna - who states that for DDD they only cover FDA approved ADR. The few remaining Charite's out there and the Prodisc are both CrCo alloys. I did patch testing which so far is negative even for nickel - which by history I am very allergic to. Probably going to send off LTT tomorrow and pray I don't have a problem w/ aluminum, vanadium, or titanium. I have exactly 1 bad disc... L5/S1. not a hint of facet arthritis, or spurs, or arthritis. Have had negative discogram at L4/5 twice now.
Has anyone had ANY success w/ Aetna getting say an M6 in Europe or fusion anywhere? I can swing paying for an M6 in Europe, but my understanding is that fusion here is close to 6 figures. i have no way of getting my hands on that kind of money. feeling extraordinarily lost and confused...
also not clear whether it's a kiss of death to pay for something and try to get reimbursed later. I don't have the heart or the pocketbook to endure a lengthy appeal. i am an MD in a medium-paying specialty, so lost work is seriously expensive for me. already didn't work for 6 months after biacuplasty.
non-surgeon MD in the US - but laid up no longer!!!
Initial injury - 2006 fall from horse - initial dx SIJD w/ nl MRI
L5/S1 discogenic pain from posterior annular tear
Biacuplasty successful but disc re-injured in MVA
M6-L implanted Oct 19th, 2011 by Dr Clavel in Barcelona
The content herein represents my professional thought and opinions in a general sense only; they do not constitute professional advice or services. if you need medical advice, please consult a licensed physician.
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