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  • #1

    Interstim covered by insurance?

    Hello Everyone!

    I've never posted on this topic, but have lately been considering Interstim. I've only been on Elmiron for five months and have been having DMSO instillations as well (main symptoms freq/urge), so I'm not sure Interstim is what I need, yet. My question concerns insurance coverage, and if those who have undergone the procedure have been covered by their health insurance providers. I have Blue Cross and have had a hard time dealing with them these past few months (they denied my first six months of coverage due to past UTIs.) Now, they are finally covering my doctors visits again, but I'm not sure they will cover Interstim placement. Does anyone with Interstim have Blue Cross? Did they cover your procedure? I hope I don't need to have the implant, but am keeping my options open. Any help on the topic will be greatly appreciated. Thanks!

    Erica [img]smile.gif[/img]
    We tell ourselves stories in order to live--Joan Didion
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  • #2
    Hi Erica:

    I am sending you the web site of www.interstim.com and the maker of the device web site www.Meltronic.com
    Please read all you can on this procedure Erica..

    I also took Elmiron and DMSO and Heparin instillations as well and try all kinds of medication and treatments , this was my very last resort before I did the InterStim..

    Many of the people on these boards have been told that the InterStim is for your IC pain..
    A lot of girls did not get any help from the InterStim to help their pain..

    I was one of the lucky ones that had wonderful success with my InterStim helping my pain and my frequency and urgency..
    I had my Implant almost three years now and doing just wonderful with it and I am back working again..

    I live in Canada and my insurance paid for my procedure and I am aware of others girls posting from the states that their insurance paid for their procedure..
    I do hope some girls will posted to you about their insurance ok..

    Also anymore questions we are here to answer them for you ok..
    See if you doctor will let you talk to one of his patients that had the procedure done by him, that would be help you a lot to Erica...

    Good luck on what you decided and I wish you all the best!!!


    ~~~~Warm Hugs: Debbie~~~
    Thinking positive has got me through to another day!!

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    • #3
      Hi Erica,
      I know what you mean about having a hard time dealing with Insurance. It seemed like I was always on the phone trying to find a solution for one sproblem or another in terms of day to day coverage. However...

      I had BlueCross/Blue Shield (BCBS) at the time and it was a breeze in terms of insurance coverage. My Uros and Medtronic Representative handled EVERYTHING. Which was really great, because I could worry about me and preparing myself physically and mentally for the surgery ahead.

      I'm wondering if it also depends on what level your insurance is. IE: If you have a differnt plan that doesn't cover as much.
      My co-pays at the time were:
      OV: $5 RX:$3,$5 or $10 ER:$25

      Ask your uros, ask your Rep (if you have one) and don't worry about being a pest. Its your body and people better have the answers you need before. Especailly when it concerns MONEY!!! At least that was the way I looked at it. They told me it was covered because it was "experimental" in the IC community. So, whoever it was that was interested in the findings was prolly the reason for financial backing and prolly the insurance companies lost no money on their end. Just my guess, I'm not really sure how it all works, I'm not sure if I really care either, jsut as long as I'm not making payments on my butt! [img]wink.gif[/img]

      Wishing you the best of luck Erica!
      y. [img]smile.gif[/img]
      Somewhere there's a reason /Why things go like they do /Somewhere there's a reason /Why some things just fall through /We don't always see them /For what they really are /But I know there's a reason /Just can't see it from this far /Maybe I don't like it, /But I have no choice /I know that somewhere, /Someone hears my voice / I thought I knew it all /I thought I had it made /How could it end this way? /I thought I knew Somewhere there's a reason /Why things don't go my way /Somewhere there's a reason /That I cannot explain /Just like the change of season, /Just may not be my turn /But I know there's a reason, /The lesson's mine to learn

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      • #4
        I also have Blue Cross/Blue Shield and I didn't have to do a thing. I had to have the surgery done twice and the dr's office handled everything.
        teri
        ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        Courage does not always roar. Sometimes, it is the quiet voice at the end of the day saying, "I will try again tomorrow".

        Comment

        • #5
          Debbie, Yvette, Teri!

          Thanks so much for your helpful information. I've actually been to the interstim website and had them send me some information, which included a video. I spoke with my doctor today and told him to check out their website, because it has a physician section. He knows of the procedure, but I don't think he's ever performed it. Yvette, I think you're right about the different types of coverage for Blue Cross. I have a PPO, but a high deductible. Of course, I got this coverage thinking it would be temporary, until I found a job with a good health plan, now I'm stuck with it. Thanks again for everyone's input. I'm sure I'll be back to ask more questions with the coming months. Glad to know you guys are here [img]smile.gif[/img]

          Erica
          We tell ourselves stories in order to live--Joan Didion

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          • #6
            I have BC/BS Blue Choice insurance, and my doctor's staff handled it all for me. My implant was in May 2001 and apparently there have been no problems in covering the implant or any of the other surgeries I have had lately, as I have had 7 surgeries in the past 21 months. [img]frown.gif[/img]
            Hope all goes well with you, as I love my implant! My quality of life is through the roof, as compared to before the Interstim! [img]biggrin.gif[/img]
            Good luck to you!! [img]smile.gif[/img]
            Life is not measured by the number of breaths we take,
            but by the moments that take our breath away!

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