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Severe spinal stenosis
Age 71yo old gal here. L5S1 autofusion, Grace II spondylolisthesis. Severe spinal stenosis complicated by significant impingement L5 nerves, both foramen caused by loss of foramenal height. Extensive spurring. Surgery ruled out due to possible need to refracture autofusion.
Ergo, surviving with opioid "cocktail", gabapentin, +++twisting, burning, stabbing pain, both calves and thighs, 24/7.
Very cooperative helping husband but wearing thin on perseverance here. Cannot imagine another 10+ years of this with a brain that's operating at warp speed.
Perhaps there is someone somewhere sharing these same issues looking at same future.
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Thank you for the advice. I wrote the insurance company and requested the doctors to appeal the the denials . I'm still waiting for an answer. I'm wondering if I should change my medicare advantage plan to a medicare supplement. I have not researched the medicare supplements in my area. I'm wary of the cost and if dental and vision are included. If anyone has any advise on medicare supplement plans I would appreciate the information.
Thank you again for your advice.
He uses a small instrument since I have Osteoporosis. I also get acupuncture, and go to PT. My main issue now is SI Joint pain.
If you were on traditional Medicare you wouldn’t have this issue.
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3 ReactionsI have original medicare with AARP as secondary. I talked to people in billing offices to canvas the best secondary. My plan name is F, without dental and vision. I pay $230 a month. Call the company and have a rep go over the coverage so you get a plan specific to your needs.
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1 ReactionThank you for the reply. How is it working for you?
Thank you. What are my alternatives?
One alternative you apparently have but you haven’t said exactly what Medicare coverage you have. I have traditional Medicare with a Part B supplement and a Part D drug plan. Medications are the most problematic due to Pharmacy Benefit Managers who dictate prices and payments but you have to play their game. You could do a straight PPO plan but they can be difficult to figure out. I’ve been working with a Medicare group to get a plan that fits my needs and they can suss out the plan that fits your needs best and it costs you nothing. Sizeland Benefits Group at 810-775-5708 and ask for Jim Neil. Plan to have on hand your insurance info, your medical illnesses and your meds when you call. Now that open enrollment time is upon us it’s a great time to change.
koneil,
for me the necessary advantage is choosing my doctors. Radiological scans don't require prior approval. And, unless the doctor's office requires it, new medical appointment aren't subject to approval.
I had proton treatment several years ago. CA Proton was aggressive at getting approval for Medicare Advantage patients. But those patients waited anxiously, sometimes for months.
plan F is the best and is no longer available. plan G is available, same as F, just a 250 deductible, once that's paid i never pay a thing but my premium i have united health care AARP along with traditional medicare . Couldn't be happier.
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1 ReactionWow. I've always been on original Medicare, and more and more, doctors are refusing to take Medicare Advantage plans, so I wouldn't consider them. I have never had original Medicare refuse any surgery that a surgeon recommended.
The reimbursement rates are a problem (for doctors) with all Medicare--as is the paperwork-- but that is a different issue.