I also have Anthem BC/BS. You may wanna check the Insurance section of the forum. Maybe they still consider the ADR thing to be experimental or something? Good luck--Mazy

I have the same insurance... thought it was the best around. Can you appeal again? What about emergency government benefits?

Hope this all works out for you...
Amanda

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We have a section devoted to Insurance items. Please take a look there, there might be more information available. I have found over the years that you did not to 'talk' with the insurance companies several times. I have treatments tnat my current Insurance carrier has rejected. This is being gone on for almost two years now. I keep writing lettings, get doctor memos to back up , look for articles in papers, magazines, etc to back up my claim.... They still say no. I am on about my 3rd time... DONT Give UP!

We changed to BC/BS for my recent surgery because hubby's insurance, which we had been covered under for several years and covered first back surgery, no longer had my NS in thier network. Thank goodness hubby works for a big company with good group coverage with 3 different insurance options. We now pay more out of pocket expense, but my NS was covered, so it was worth the change to me.
I have heard that sometimes surgeries get denied the first and sometimes second time, but then are approved. So keep trying for approval, or if it's possible, look into changng insurances, if you are lucky enough to be in a big group coverage siuation like I was.

Good luck!

Lynn, I am so sorry to hear about you losing the insurance appeal. I hope you would try the appeal again. I have read that it sometimes takes up to 5 appeals before it will be approved. Darn insurance companies--most of them only care about the bottom line, which is the "almight dollar". Maybe your Dr would change your pain meds to something stronger to help you out until you can get the surgery done. I am sorry you are in so much pain. Hang in there.

There was a post on the old SH that somebody had the same insurance as you and finally got it (ADR) approved. If I can remember who it was, I will let you know.

hi and welcome.
i also have anthem they have been great.
personally i am going to think its the ADR also.
alot of insurance companies have a issue with this.
have you discussed with your dr using your own bone as a graft???
thats what my surgeries were with.
they were approved the day the surgical scheduler called them.

keep up checking this out.
don't give up hope!!!
let us know
terri

Lynn,
Seems to me there have been a few posts on here that say insurance will not cover 2 level ADRs in the US. You might want to do a search. I also vaguely remember seeing that it took some preserverence to get authorization for one level ADR as well. Try looking in the insurance section. Sorry I'm not more help.
Teri

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