Don't know what to do

[Qikdraw]

Well I found out today that my insurance will cover me for nothing and that they will review it again in 2010.

So don't really know what to do now. I guess I'll still go get a second opinion and see what this other doctor has to say.

Lynette

Can you tell me who your provider is and what your policy is? How long have you been with them too. My wife knows a lot about insurance and got her long term disability provider to actually follow their policy rather than deny her. (They were shocked she actually read her policy and understood what it meant) I can't promise you anything, but my wife can look it up.

Insurance companies deny people, even when they are covered, because they can get away with it. Any fines they eventually get don't come near to how much they have made by denying coverage.

PM me with the info if you like.

*edit* My wife also asked if you had changed insurance carriers, and if you did how long in between did go between coverage. They used to deny on the 'pre-existing' excuse if you changed coverage, but they added a law to add a grace period for you to reenroll with another carrier and not have the 'pre-existing' thing. (if you haven't guessed by now, insurance companies are evil)

Brad

[ladare]

Lynette, your feeling of "the whole thing scares the crap out of me" is a VERY common feelling. That's another reason to not rush into surgery too soon; you need time to process a ton on information and feelings. I felt very alone exploring the whole idea of scoli surgery until I found this forum. I guarantee you will never feel alone as you go through this journey as you will have a world of support here, and so many hints and tips on how to deal with issues. Welcome to the scoli family!

Lisa

[lynetteanne]

Wow you guys are so wonderful - you brought tears to my eyes just being so comforting with me. I'm not getting much of that understanding or comfort from anyone right now. My mum of course is wonderful and I thank God for her and I ADORE my kids.

I can't thank you enough for your support.

God bless,

Lynette.

[debbei]

Lynette,

When I first came here a few months ago, I felt as though my whole world was crumbling around me. I didn't know where to go or what to do first. The members here gave me so much good advice on so many of my stupid (at least I thought so) questions. They continue to do so. Don't think anything is to silly to ask. Now that I have my surgery scheduled, I feel much more calm, but this is so much to go through. You have to give yourself time to get used to all of this.

Keep posting, ok?

[CurvySAT05]

Lynette,
Your local chapter of the Scoliosis Association should be able to provide you with more names of Scoliosis Specialists in your area. The surgeon who did my last surgery has A LOT of experience in scoliosis, but is not yet a member of the SRS because of the fact that they have to do much work on research to remain a member. He might join the SRS at some point, but hasn't yet.
I found out about this surgeon from my local chapter of the Scoliosis Association (I am actually on the board of this chapter) and am really happy that I see him. I would not have found him otherwise.
Like Pam said, It would be best for you to get a second opinion from an Adult Scoliosis Specialist rather than just a spine specialist. While the spine specialist might have a knowledge of fusions and how the spine works, a Scoliosis Specialist has experience of long fusions required with scoliosis, de-rotating and all the other "co-morbidities" resulting from scoliosis.
While scoliosis surgery is hardly ever an emergent situation, it would be best to do it while you are still young (probably within the next 5 years) to get a better correction. If you are not having problems with too much pain, numbness, weakness of the legs, etc. than you are probably alright to wait until your kids are a little older, or when your insurance will cover you.
If you want the name of a surgeon other than Dr. Moreno who is close to you, I might be able to find one for you. Just let me know, its fine to PM me and let me know what area you live in.
Keep calling the insurance company and try to go up the chain of command until you can get something covered. My insurance had me go to multiple surgeons before they authorized my surgeon, but because of persistance my hard work paid off.
Good luck with your insurance company. If possible, get a copy of your recent x-rays to take with you to the second opinion. This way you can save a little bit of money by not having x-rays taken at each new doctors office.

[lynetteanne]

Thanks Debbe - I will keep posting.

Curvysat05 - thank you so much for your help also, if possible could I please have a contact number for someone in the Dunedin/Clearwater area of Florida? I've already seen Dr. Moreno. Then I will just cancel the appointment with Dr. Piazza on Monday, he's a good spine surgeon, but not a specialist in scoliosis.
Please if possible let me know as soon as you can.

Thanks again.

[lynetteanne]

Brad - the insurance company is Assurant Health Savings.

A year ago the insurance was changed - I have to follow what my ex does with the health insurance as he pays it for me and my boys. It was then put down as a pre-existing back then, actually I think that was two years ago. Then he just changed the company a couple of months ago again and again I had to sign a rider saying it was pre-existing. So I don't think there's a lot I can do about the insurance situation.

[ladare]

Lynette, any possibility the pre-existing condition was listed as something vague like "low back pain"? That might be a pre-existing condition insurance companies would balk about. But if it's listed as scoloiosis, which you were likely born with, maybe they would reconsider the pre-existing condition clause. Just brain-storming here.

Lisa

[lynetteanne]

It was listed as severe scoliosis because I knew that I had that nine years ago. So whenever I've had to change insurance companies I've always told them I have severe scoliosis.

If you have any suggestions as to what I do next or where I would go etc. as I'm clueless right now.

Thanks.

[txmarinemom]

It was listed as severe scoliosis because I knew that I had that nine years ago. So whenever I've had to change insurance companies I've always told them I have severe scoliosis.

If you have any suggestions as to what I do next or where I would go etc. as I'm clueless right now.

Thanks.

I'd really suggest you consult an attorney who specializes in insurance matters, Lynette. I've personally never seen (although, of course, that doesn't mean it isn't so!) where they can pop you for something like scoliosis *unless you've sought treatment for it* ...

Do you still have a copy of the application paperwork you filled out - and how it was worded where you HAD to tell them? I mean did you just volunteer it, or did you provide more than what the application specifically asked? If so, and you had NOT sought treatment for it, you MAY have a loophole ...

(of course the insurance company would NEVER tell you that ...)

Just brainstorming here. I was diagnosed with scoliosis at 10, but never TECHNICALLY sought treatment for it after I came out of the brace - even though I saw a pain management doctor for 4 years ... and therefore, never had to mention it ...

Regards,
Pam