Pain Management
Fri, 07/03/2009 - 09:47
SCS Cost
I finally have my first appt set for my trial. However, they brought it to my attention that my insurance may not even cover the scs. Shouldnt they have mentioned this to me before leading me down this path A YEAR ago?
I have medicare as my primary and BCBS as my secondary. They said they dont have to get approval from Medicare, and Medicare covers 80%, however they do have to get approval from BCBS.
I called BCBS yesterday and they said that if its deemed investigatory or experimental they will not cover it. Is the SCS considered that?
I am so bummed that I have finally come to terms with getting this done and now the insurance may come in the way. I am in no position whatsoever to pay for this.
Being its a holiday weekend I am not able to get the proper code from the doctor office for the SCS for the insurance company to get the proper answer. I have to wait until Monday.
So I thought maybe I can get some answers on here until then. Thanks everyone.
Until then, hope everyone is able to enjoy their holiday weekend!!
Take Care.
Alina
_____________
Broken mom of two lovely girls, 2 & 4yo. L4L5 Laminectomy, Then revision 5 weeks later, found out had broken vertebrae, 2 large bone spurrs, severe re-herniation, removed facet joint. Currently have herniated L4L5 (again!) as well as L5S1 plus an annular tear. Not a surgeon in site will help me due to the damage caused in 1st surgery.
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i have medicare and bcbs. they will pay for my scs which has been around for 30 years. i don't think youll have trouble. why not give another call maybe the 2nd rep will tell you yes. if so get confirmation no.
pete
Banned from Spine-Health
My BCBS insurance will cover SCS too, but the medical diagnosis codes need to be the right ones (e.g., radiculopathy, arachnoiditis). Some uses (but not all) are considered experimental, so it's important to use the right codes. Sometimes insurance companies have their medical coverage policies online and you should be able to ask for them, too.
I have BC/BS as my primary insurance and they are covering my nerve stimulator, however, they require a psychological evaluation first. From what I understand,this is a requirement of most insurance co's.
have BCBS and they covered both the trial and permanent placement, no problem. I did have to have the psych evaluation, but my doctor required that before insurance did.
P.S. This technology has honestly been here since the 60's - not experimental at all.