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Reply With QuoteInteresting question. I have no idea, but would love to know.
This is a discussion on complications and insurance coverage within the Health Insurance forums, part of the Insurance and Travel Forums category; Does anyone know what happens with regard to insurance coverage if complications arise after ADR surgery? If a more prolonged ...
complications and insurance coverage Does anyone know what happens with regard to insurance coverage if complications arise after ADR surgery? If a more prolonged hospitalization turns out to be necessary, for example, will insurance cover treatment of complications from ADR surgery, even if coverage was refused for the ADR surgery itself?
Suppose, just for example, that you come down with pneumonia while still in the hospital recuperating from ADR surgery. Will an insurance co. that refused coverage of the ADR surgery still be compelled to cover hospitalization to treat the pneumonia?
Or what if the surgical wound gets infected? Will insurance have to cover treatment of the wound infection?
Does the answer depend on the particularities of insurance policies and their provisions for coverage? Or is there a a general answer?
I ask because unless insurance kicks in at some point, going ahead with ADR surgery without insurance would seem to have the potential to bankrupt the unlucky patient.
A herniated and serverely degenerated cervical disc C6-7 seems to cause all my symptoms. In the past year, the disc immediately below C6-7 also began showing up as some 90% degenerated. But it does not appear to be causing any symptoms as yet.
My surgeon recommended replacing both discs with 2 Prodiscs. My insurance refused coverage.
Should I do surgery? Pay cash for replacement? In Germany? Which surgeon and artificial disc? One level or two?
Re: complications and insurance coverage Interesting question. I have no idea, but would love to know.
31 years old- 1/06- In wreck with 18 wheeler at 25 years old; 6/06- Head on collision on Interstate, both wrecks other drivers fault. Numerous MRI's, PT, chiropractic, acupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc at 29 years old. Pain and medication free as of October 2010!Mommy to Emma- 8 years, Ava- 6 years & had baby Eli after ADR, via c-section on March 25, 2011, completely pain free still!
Re: ADR revision and insurance coverage A follow up question just occurred to me that some should know the answer to. Suppose subisdence occurs after ADR surgery, and surgical revision is necessary, maybe a fusion.
Would insurance be likely to cover the revision? Most US insurance cos cover fusion. Would they cover fusion as part of a post ADR revision?
A herniated and serverely degenerated cervical disc C6-7 seems to cause all my symptoms. In the past year, the disc immediately below C6-7 also began showing up as some 90% degenerated. But it does not appear to be causing any symptoms as yet.
My surgeon recommended replacing both discs with 2 Prodiscs. My insurance refused coverage.
Should I do surgery? Pay cash for replacement? In Germany? Which surgeon and artificial disc? One level or two?
Re: complications and insurance coverage No expert here, but if I had the funds I would get the m6's or the ca disc. Those 2 I believe or vastly superior to the pro discs or prestige. If you have to go with the 2 here in the states, I would even choose prestige over pro discs. I would guess insurance wouldnt cover a revision as u did this surgery with our their "authorization". Just make sure u have funds for both the intial surgery and a possible salvage surgery to fusion. It really sucks, but thats how it is. In the mean time, those with funds and people over seas will continue getting better treatment then us. I know we have to be careful with new things, but we are on the 3rd generation implants which are a heck of alot better than original ones. Plus, I dont see any reason why they can be fast tracked for the neck as its easier revision than lumbar ones. But we have to sit here and twittle are thumbs and wait 10 years for super good cervicals to hit the market. I again say all fda employees should sign a sheet saying they will not seek over seas treatment at all for anything since they know whats best. I would almost promise u a neurosurgeon would have his butt on the plane to europe for cervical adr in heartbeat over any cervical fusion. Again all advice is my opinion and speculation, u ultimately have to research, ask doctors who do both, and make your own decisions and opinions.
Riding 4 wheeler and playing basketball. Collide with guy in mid air and I hit concrete on one leg and then fall down. Wake up in pain cant move for few hours, fine few days later. Back never the same.
dec 2007 horseplaying with father, contained l5-s1 disc herniation with sciata on right leg, traction helps and time, pain free, diagnosed ddd l4/l5 and l5/s1
Re: complications and insurance coverage If you have any money at all dont get the pro-disc in your neck...
Matter a fact my pro-disc was free and I wish I never had it...
I gave you fair warning beware...
C4-5: Mild disc height loss with central annular fissure. Small broad-based left paracentral disc protrusion. Moderate central canal stenosis-the disc protrusion abuts and mildly flattens the left ventral surface of the spinal canal.
C5-6: Disc desiccation with mild height loss.Diffuse discosteophyte bulge anduncovertebral joint hypertrophy, moderate central canal stenosis- Severe neuroforaminal stenosis bilaterally, right greater than left
Re: complications and insurance coverage [QUOTE=herniated C6-7;16445]Does anyone know what happens with regard to insurance coverage if complications arise after ADR surgery? If a more prolonged hospitalization turns out to be necessary, for example, will insurance cover treatment of complications from ADR surgery, even if coverage was refused for the ADR surgery itself?
Suppose, just for example, that you come down with pneumonia while still in the hospital recuperating from ADR surgery. Will an insurance co. that refused coverage of the ADR surgery still be compelled to cover hospitalization to treat the pneumonia?
Or what if the surgical wound gets infected? Will insurance have to cover treatment of the wound infection?
Does the answer depend on the particularities of insurance policies and their provisions for coverage? Or is there a a general answer?
I am going to try to PM you.
Yes, insurance can refuse to cover complications. Generally, they do not. They can have hospital eat the charges, so to speak. if you get post-op infection. they should treat your pneumonia.
You are not entirely crazy and I will try to answer some of your other questions.
R
DDD or DJD
ADR recepient.
Mother of four, advocate and insurance fighter.
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