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  • Insurance denied me

    Hello everyone,
    Well my insurance denied my trial surgery for a spinal neurostimulator. My two docs working with me are convinced that if we fight it through appeals, we'll eventually win. That gives me hope, but the problem is that I've been out of school for about 6 months and I was assuming I'd already be over and done with the trial surgery at least, by the time school starts again in January. I'm worried that I won't be able to handle my courseload, as my pain seems to increase since I was diagnosed with Adenomyosis in the spring.

    So my question is, has anyone been denied before and kept fighting? Did you end up getting the surgery, did you give up? etc etc. Thank you so much for any responses!
    Allison, 25, living with IC since 2002. Add me on Facebook! (search Allison Jacobs)

    Conditions: (known)
    IC, Chronic Pelvic Pain, Neuropathy, Adenomyosis (hysterectomy to "cure" this), Vulvadynia

    Medications:
    Elmiron--200 mg twice daily
    Cymbalta--90 mg once daily
    Various pain meds, rotating

    Treatments:
    Spinal Nerve Stimulator implanted 5/10, mostly unsuccessful
    Hysterectomy 9/09
    D&C and hysteroscopy 8/08, somewhat helpful
    Mirena IUD began 12/07, unsuccessful
    Lupron Depot 6/07-8/07, unsuccessful
    Hydrodistention 2004, 2007
    Physical therapy 2003-2006

    "Tomorrow is the most important thing in life. Comes into us at midnight very clean. It's perfect when it arrives and it puts itself in our hands. It hopes we've learned something from yesterday."
    John Wayne

  • #2
    I don't know how long it takes. I know when I had mine in 2002, I had to go through so many other meds and treatments before they would approve it, plus I had a friend that was a VP at my insurance company that helped me to the point that I was able to see that doctor since at the time she was out of Network. Of course, by the next January, our insurance changed and I was allowed to go to any out of network doctors. We just had to pay a higher copay.

    I am so sorry you are going through this. I would definitely try to see if you could get a nurse management person that most insurance companies have and get their assistance. I find even now, can all my insurance company and talk to a nurse manager if I have any concerns.

    Tracey

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    • #3
      I know many insurnaces will not pay for the spinal cord stimulator BUT will pay for the Interstim.
      I am so sorry you are dealing with this. When I was going to have the spinal cord stim it has a nightmare with the insurnace but I decided against it and went with the Interstim instead.
      DON'T GIVE UP!! Keep fighting and you never know what they will approve.
      If you have your drs on your side that sure helps the fight!
      Hang in there and I hope things work out for you!!
      Current diagnosis
      Severe IC, Severe Endometriosis(keeps growing back all over despite surgeries and treatment), Chronic ovarian cysts, Chronic Pelvic Pain Syndrome,Fibromyalgia,Inguinal hernia, bursititis of the hip, Migraines, IBS, Celiac disease, CROHN'S Disease, Chronic Constipation, Chronic anal fissures, Vulvodynia, Pelvic Floor Dysfunction, Pirisformis muscle spasms,vulvar vestibulitis, chronic insomnia, Burning Mouth Syndrome, Brain TUMOR, Chronic Lyme Disease,Temporomandibular Joint Disorder,Degenerative disc disease,Arthritis.
      Allergies: Elmiron, Levaquin, Sulfa-Anaphylactic shock,Morphine, Doxyclycline,Cipro

      Treatments I have tried:Bladder instillations, Oral meds-Elmiron, Elavil (amitryptyline), Hydroxyzine (Vistaril & Atarax), Ditropan, Levsin, Urispas, Urised, Pyridium, Cystoprotek, Desert HarvestAloe,antibiotics,Ultram,Neurontin,Valium,Tramadol,Lunesta,Ketor olac,Cipro,Meloxicam,Dilaudid,Morphine,Vicoden,Darvocet,oxycontin,Lyri ca,Cymbalta,Nortriptyline,Enblex,Baclofen,Clonidine,oxybutynin,Detrol, Nitroglycerine ,Vesicare,Sanctura(there are more but this is enough)
      Physcial Therapy, Cystoscopy with Hydrodistentions, Numerous Nerve Blocks, Neuromodulation-including Sacral neuromodulation(Interstim) and post-tibial nerve stimulation (Urgent PC-12week), Botox, bladder instills, physical therapy, natural(herbs)Current meds: Long list..just email if you are interested
      Interstim implants--8 plus surgeries for them.
      I am selling IC awareness bracelets, keychains, pens and pins..if interested please email me! ThanksFeel free to email me at [email protected].
      One day at a time

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