Has anyone been covered by Health Net or Blue Cross of California?

robert
good deal i wish you the best of luck.please keep us posted.
chuck

chaswen,
Thank you, about 6 more weeks before I "cross to the other side" Praying I can be one of his cures. Nervous but hopefull.
Robert

robert
you'll be one for sure [one of his cures]
happy holidays may they be pain free
chuck

Chuck,
Thanks, as it turns out I also have a bulge at L5-S1, that has beens stable since my MRI back in '01, and has normal signal on MRI, but just to be sure, I am planning a discogram in the US (I just returned from Thailand completing papers on a new condo I purchased there), if concordant symtems, then I get 3 discs.
I hope the Prodisc trials prove what probably everyone on this forum believes and that is that ADR is far superior to fusion in the right clinical setting and insurance companies denying people of this option will cost THEM more in the long run over fusion, possibly in the form of class action law suits. If the approval of the Prodisc shows that to be the case then they will have no legs to stand on.
They have seem to taken one study out of many and used it to apply it to their own beliefs to support their bottom line, $$$$.

[ans]

I have BC of CA and could not get a straight answer from them, especially from Utilization Review. A partner of Delamarter's said that BC w/be the last to approve ADR's.

Good luck Dr. Robert.

Allan

Allan,
As I approach 60 I will become elligible for Military health care, and can't wait to hopefully tell BC of CA. to go jump in a lake.
Of all the companies I chose years ago who would have believed that one of the most reviered names in the insurance business would end up with such a vile reputation.
I also had discussions with the Delamarter group, he has reviewed my MRI but alas I had to give up any hope of seeing him because of the insurance company' policies. Shame on them.
Robert

Allan,
Good luck to you too. It looks like many insurance businesses are more interested in not having to deal with patients, than TO deal with them, and with the paradoxical trap of living in fear of having no insurance at all, they think they have us by the lower anatomic parts. Things will change, I fear for the worse before they get better.
Robert

[ans]

Thanks for the words Robert.

I wish there were better long-range ADR studies, esp. w/regard to the facet problems we're hearing here, etc. Also, each study should incorporate how many ADRs a doc has done in the matrix w/other variables. I kinda think that Johnson and Johnson partially screwed the pooch by having such high mark-ups with Charite's (e.g. $11K extra vs. Europe). I'm meandering: I partially blame the insurance problems in that the Europeans have had such lousy data imo.

Regardless, I wish you well in your decision and recovery in your Thailand pad.

Allen,
Thanks, you are right, J & J charge (I believe )about $11,000- $12,000 for each Charite in the US (or so I am told), they charge half that in Asia. Go figure.
I look at this way, I wouldn't think twice paying $20,000 for a new BMW, but paying the same for a chance at a normal life seems cheap to me. Irregardless of what the insurance companies decide.
I can see the bad faith argument to this side also, these companies are more than eager to accept our premiums, but when it comes to paying out, they will come up with excuses such as "experimental" to not pay for what is needed.