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My insurance doesn't cover SCS

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:23 AM in Pain Management
Well, after all of the emotional things that you go through to decide about a SCS the rug gets yanked out from under you when you find out that SCS is not a covered procedure. It was my last hope of ever getting relief from this pain. Now I have to try to reel myself in and realize that this pain will be with me for the rest of my life!!!!!! Tons of fun X(
Saima
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Comments

  • Hi Saima,

    I'm sorry to hear this.

    What is SCS? I am not familiar with it?

    Why are you not covered, please explain. Maybe someone on these boards may be able to offer up a suggestion to help you?

    X(
  • My insurance company excludes some treatments and procedures at their choice.
    Saima
  • Saima,

    That is a tough pill to swallow. Is there any chance of having a review of your case to show that it is medically necessary? Can your doc do anything to help with this???
    I hope that you are able to get some resolve and get this SCS done. It has saved my life in more ways than one. I will keep you in my thoughts and prayers.

    Hugs,

    Amy
  • I have called the union represetitive but just got the voice mail. My husbands company is in contract negotiations and I am sure that I won't hear from them soon. Also my PM doc has just opened a private practice after being with a large medical facility and his staff does seem inexperienced. I am going to pursue this further and hope for the best.
    Thanks, Saima
  • I would call around. I know that there are places here in Nevada that if there is something that is medically neccesary that you have to have they will work with you as far as pricing and paying. YES it is a spendy unit. I know that the the hospital and doctors around here will have you pay based on your monthly income. CAll the hospitals and doctors offices and see if this is somethig that they can do. I would even contact to manufacturer of the device and see what they say
  • I wish you luck with trying to find a remedy to this problem that has come up. You might talk to your doctors about monthly payments. I am able to make payments on the amount my insurance did not pay. Hang in there!!
  • About how much does a SCS cost? I have seen some references but they are so far apart that I don't know what is right.
    Saima
  • I read that Boston Scientific has a program that may be able to help you. Look at the controlyourpain.com website and contact a representative for more information. The reps will help you with the insurance company or possibly see if you qualify for a clinical trial. If that doesn't work out try Medtronics. Medicare also covers SCS implant if you qualify.


    Good Luck with your research and I hope you get your trial soon.
    O-

  • From what I remember my old PM said the devise along with the prcedure was around the 20K range. That could be because he was a totaly rip off also. LOL So I couldn't be sure on that one
  • Somewhere I thought that I read in the $75.000 range but I have read so much that I must have read it wrong. The drs office said that they would work on it but for the next few days anyway we have to deal with a hurricane.
    Saima :)
  • I have a Medtronic SCS that was implanted about 4 months ago. It was just under $160,000 for the surgeon, anesthesia, hospital, and the unit, leads, etc.
  • Just as Bionicwoman said, my Medtronic Rechargeable unit in total cost around $140,000 after you take into consideration the trial implant, the permanent implant, anesthesia, surgery fees, programming the unit, after care, blah blah blah. I was also told not to lose the external control unit as it would cost $1000 to replace!! Needless to say I am very mindful of where it is at all times!

    Take care and I hope you can get this taken care of quickly!

    Amy
  • Well what I had seen about the cost is true. No wonder insurance companies try to deny these procedures. But still they should take care of their clients. Hopefully next week I can get some answers it all depends on how much damage this hurricane does.
    Thanks everyone, Saima :)
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