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UNICARE? THEY DON'T CARE! WE NEED HELP!!!

AnonymousUserAAnonymousUser Posts: 49,900
edited 06/11/2012 - 8:25 AM in Health Insurance Issues
My husband has DDS in his lower back has been out of work for 2 months now, we've been to see all typed of doctors and we are getting the same answer every where...disk replacement, only UNICARE won't cover it! He's in pain all the time where can we go for help to either get this covered or to get him help we can make payments on? I've done everything I can think of now i need help fom outside my brain!! Anyone tell me something point me in the right direction. UNICARE says it's experimental surgery and i say the entire medical profession is experimental you never know how someone will react to anything you do to them till you do it! how can an insurance company go against what the doctors are saying is best for a patient anyway? HELP US PLEASE!

Naomi :''( :crying:
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Comments

  • dilaurodilauro ConnecticutPosts: 9,715
    I guess I am a little shocked that you mentioned that all the responses from medical professions regarding your husband DDD call for disk replacements
    Under all but the most severe cases of DDD, surgery is generally not considered.
    DDD is basically the aging of our spines and it can be controlled and managed by approved physical exercises and NSAID.
    You did not mention of your husband has had a MRI and what did the doctor tell you about that.
    Also what is the current medications he is on
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I also have DDD and facet arthropathy. My doc said that he would never consider ADR because it is so far from being perfected. I could not imagine this being suggested for DDD unless the circumstances were extreme.
  • Really? Im 100% pain free from my 3 level ADR. Im horrified of being fused, especially at 3 levels. We already know with 100% accuracy that fusions beget future fusions due to adjacent level deterioration,...no thanks. AT least with ADR, there is a descent chance this wont be the case due to motion preservation.

    The europeans have studies showing ADR is safe and effective when implanted in qualifying patients but the FDA doesnt accept their studies and is too slow to act. Finally, the FDA has already approved 1 level as safe and effective. Give the FDA a few more years and soon 2 level will be approved , and so on.

    I know tons of people who have had multi level ADR and 5 years later they are still doing great! I dont see quite as good outcomes with fusions, just my own personal observations based on 12 months of reading patient outcome stories.

    Anyways, to OP, you can get in on free clinical trials!! Some wont gurantee you will get the disc(as typically 2/3 get the disc and 1/3 gets fusion) but some trials do gurantee you get the disc. The newer disc are probably better anyways. You can also look up laurie todd teh insurance warrior in google and follow her advice on how to get insurance to pay. Only Aetna pays without needing appeals, and signa usually pays upon appeal, and united only sometimes pays. All others , well, even with laurie todd's advice, its doubtful they will pay. Mortgage the house or whatever and get it done, and then get laurie todd;'s book and fight them for reimbursement. Best advice I can give. If you are only getting 1 level done, fusion may not be so bad. My doctor, dr bertagnoli, has todl me that he fears for patients the more levels they are getting fused, its a domino effect.

    Well, good luck!
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