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View Full Version : Interesting summary of insurance coverage by CIGNA for all treatments for scoliosis



Back-out
06-13-2010, 12:28 PM
Bumped into this courtesy of Google.

It's CIGNA's statement of coverage of all scoliosis treatments for all patients with idiopathic scoliosis, along with what is and is NOT covered and why, including a literature review. Linda could probably cite many similar and probably better summaries, but this was handy and useful to me as a reference point, though I don't have CIGNA.

I found the section on braces including Spinecor to be especially interesting plus comments about surgery, including endoscopic (not covered).

Jess note Lonner has several studies cited. Clearly he's quite the researcher!

BTW the discussion developing in the other thread (about "complications" article) is NOT only about revision surgery, but about expected (by me) changes in govt sponsored coverage for primary surgery as well, especially for seniors - all to be facilitated by MORE outcomes research.

Something tells me you knew this risk in the back of your mind or you would not have kept paying the premiums on your employee retirement healthcare plan when you now have Medicare! (Smart move)

http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0113_coveragepositioncriteria_idiopathic_scolio sis.pdf

jrnyc
06-13-2010, 01:20 PM
one should not trust Medicare...ever...and the wisest thing, if one can do it, is to keep regular coverage, not "Medicare advantage" coverage, which i know personally that some doctors wont take...
by keeping the regular coverage had before retirement, one is not at the mercy of what the govt decides to do...or not do...

jess

loves to skate
06-13-2010, 08:34 PM
It may be a smart move to keep paying for an employee retirement health plan if you can afford it, but that is not always offered as an option. I worked in health care for over 30 years, 25 years with one hospital and it was not offered to retirees. Maybe the Docs in NYC don't take Medicare Advantage plans, but that doesn't mean that it isn't accepted in other cities or states. There are many excellent scoliosis Docs in other cities besides New York City. My Medicare care Advantage plan covered most of my medical costs even though my Doctor didn't have a contract with my plan. Out of pocket, I only paid $750.00 for hospital costs and $1,500.00 to my Doctor for both surgeries and nothing for the rehab hospital. I'll bet most scoliosis patients pay a lot more out of pocket that I did. My monthly premiums were only $119.00 per month and included a drug plan. Each insurance plan is different and one has to study and explore all of the plans available to you in your area and make an informed choice. I chose a PPO plan and was very happy with it. Unfortunately, the government will be eliminating Medicare Advantage plans, so I will need to start over and research other plans that will be available to me. I am quite sure it will be much more expensive. I am fortunate my surgery is behind me.
Sally

jrnyc
06-13-2010, 09:25 PM
no, i'm referring to doctors in CT who wont take advantage plan...some that i've gone to myself..and that was just for in office and injections done in office...no surgery involved!
i just kept insurance i had when i worked, but now it is much more expensive!

jess

Confusedmom
06-14-2010, 10:24 PM
That Cigna document IS interesting--makes it look like these decisions are black & white! How did you get ahold of it? I would love to see similar things from other insurers.

Evelyn