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Degenerative Disc Desease and Artificial Disc Replacement

From: carmen14 - on 01/29/2010 11:37am

Does anyone know if any insurance companies will cover the surgery when doing a full disc replacement with artificial discs?

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14 Responses

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on 02/01/2010 11:29am

I had this question myself as I was going through what seemed an endless period of proving "conservative" measures would not indeed resolve my pain, doubled the time of the norm since I grew impatient and changed doctors only to be forced to start again at square 1. What I was told by my surgeon (YAY!?! I finally had total disc replacement at the L5-S1 lvl about 10 days ago) was that I had the only "major" insurance company that will in some cases actually cover this surgery, which is Aetna. I ended up being a candidate for a research study so my insurance was mute point, so I'm not sure what qualifications you have to meet, plus this was my surgeon speaking not my insurance company, so take it with a grain of salt ;-) Best of luck to you!

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on 02/04/2010 7:38pm

As far as I know, Blue Shield/Blue Cross covers single level disc replacement surgery. Not multi-level.

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on 02/05/2010 12:31pm

Depends on the state if you're a BCBS patient. Some states BCBS reimburses, others won't. I believe United Healthcare is reimbursing now though... Not sure, anybody know for sure about that?

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on 02/26/2010 12:32pm

I have heard that Blue Card International will......Blue Card International is rare, however ex pats coverage does too . If you have regular Blue Cross and yours includes International coverage and go overseas for surgery, pay it out of your own pocket, call Blue Card International while you are there and turn in the claim form with all receipt and invoices they may reimburse you.....some have gotten total and some partial, no real standard.

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on 03/22/2010 4:44pm

I have had disc replacement surgery and fusions and my insurance did pay for the surgery. the best thing is to contact your insurance and ask questions. Only that will answer your questions about the surgery, not everyone has the same benefits

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on 03/22/2010 5:18pm

Hey, 12behealed, did you have surgery in the USA, if so can you provide more information and your recovery effects of this process. Perhaps a hospital or surgeon. I am in need of multi level areas of improvement. I was given the option by one surgeon to have a fusion plus a pro disc replacement in the lumbar and a fusion plus a pro disc replacement in the cervical. Any information would be helpful.....Thanks, Dave

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on 03/30/2010 6:17pm

Please tell me who to contact for that study! Or doctors that go above and beyond that have helpede you! I have so many things wrong that no one will help me except throw pills at me. I don't want that - I need to find a way to correct DDD problems in nearly every disc.

I've been turned down by so many I need help!

email (private will not disclose I promise) dnduu3x@yahoo.com

Thanks!
Dee

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on 06/24/2010 10:25am

Kaiser Permanente covered my surgery. I had BCBS and they denied all my appeals, I fought with them for years.Had 2 lumbar discs replaced with Prodisc.

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on 06/28/2010 11:34am

While I realize each case it unique, can anyone give me an "average" cost of back surgery to repair DDD in the lower back - probably 3 discs. I'm trying to weigh the options, as since I'm in a wheelchair, rather than trying to walk (got harder to do, then impossible) I'm in no pain when sitting or laying down. I'm thinking I may have to "save" my pennies for a couple of decades before I can afford the cost. I wind up paying 70% of the cost.

Thank you in advance.

Dobermom

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on 06/28/2010 6:41pm

If you go to Germany it may cost 60K, however, the best way to know is contact Stenum Hospital in Germany, they are on the web, and also have a rep in the USa, they will look at all of you medical records if you send them and send you a quote. Another famous german surgeon is Dr Rudy Bergnatoli, and he can be found on the web, he also wil review your medical records and quote you, however, it may cost a few hundred dollars. A great resource is Mark Mintzer atwww.globalpatientsnetwork.com Mark has received many artificial discs himself and helps other people find options, he is in California. I also have advanced disc degeneration throughout my spine and researched artificial disc replacement as an option. I revisited several surgeons in the USA after my insurance repeatably denied payment for artificial disc replacement and found out that in addition to the disc degeneration I have MS and it has been most likely been present for some time, I and many doctors just pointed all issues at the known disc degeneration for years. Make sure disc degeneration is the cause. Many symptoms are the same as other causes, just for example look up Multiple Sclerosis on Wikipedia. MS is rare and you most likely do not have it, just an example. Best of luck to you!

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on 10/23/2010 6:37pm

I am preparing an appeal in anticipation of denial of coverage by my insurance company for artificial disc replacement surgery (ADR). I am collecting information for the precedent section of my appeal. If you were approved by your insurance company for ADR, I would GREATLY appreciate the following information.

First Name, Last Name
City, State
Insurance Company
Procedure Approved
Date Approved

Many ADR patients desperately need this information to support their appeals. If you do not mind me sharing this information with other patients making appeals, please state this in your email. If you would prefer not, I will honor your request and keep the information private. You can forward the information to the following email address.

adrpaidfor@comcast.net

If you would like to communicate with me first to develop a comfort level that I am just a regular guy trying to get what I should from the insurance company and help other patients at the same time, please send a note to the same email address.

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on 10/27/2010 11:48pm

Hi, I will email you extensive appeal information I repeatably got denied from Blue Cross of Minnesota. I also collected testemonies fro people all over the USA and some state are covering. The Blue Cross International will cover or reimburse. The contact information will be on there.

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on 06/30/2014 1:39pm

djprieve,

Can you send me the info that you have on Blue Cross MN? I am in the process of trying to get this approved and it is a nightmare! I know it is an old thread, but the info could still help. -Thank You!

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