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Insurance Coverage for Shock Therapy

Posted by Steve K. on 8/21/01 at 13:34 (057441)

I live in Illinois. My insurance carrier (Blue Cross/Blue Shield) refuses to cover extra corporeal shock therapy for my heel pain even though I have spent eight years using other therapy (cortisone, immobilization, stretching exercises, strapping, heat therapy, etc.), and an orthopedic surgeon refused to operate saying it would not work. Blue Cross maintains that the 'medical efficacy of this form of treatment has not been established.' Do you know if Blue Cross has ever covered this procedure in any other state, or how to pursuade them that this procedure works?

Re: I have BCBS too....

Carmen H on 8/21/01 at 14:42 (057445)

I'm not a doc but I have BCBS and my experience has been that they are bad about covering things like that. I called them about orthotics and they said it's not a 'necessity'. I replied 'So you'd rather me go and get surgery for a few thousand dollars then to help me pay for $400.00 Orthotics that may fix the problem?' She replied 'Yes.'
So good luck and let us know what you find out. That would be the direction I would take too if the shots fail for me.....If you are determined to get coverage and want to pursue it I guess I would start with a lot of research on the procedure, get a letter of necessity from a doctor and write them a letter with the cost of surgery and the cost of this procedure, everything you have tried to get rid of PF, the cost that will continue to incur if you have to keep going to the doc at their expense etc etc etc.

Re: Insurance Coverage for Shock Therapy

Dr. Zuckerman on 8/21/01 at 17:55 (057470)

Give the people at healthronics a call. I was told that there
have been some insurance coverage with the blue shields in
Illinois.
I have been able to make some deals with one NJ Blue Shield called the
devon plan.

Was very surprise. But did do it .

Re: I have BCBS too....

Carmen H on 8/21/01 at 14:42 (057445)

I'm not a doc but I have BCBS and my experience has been that they are bad about covering things like that. I called them about orthotics and they said it's not a 'necessity'. I replied 'So you'd rather me go and get surgery for a few thousand dollars then to help me pay for $400.00 Orthotics that may fix the problem?' She replied 'Yes.'
So good luck and let us know what you find out. That would be the direction I would take too if the shots fail for me.....If you are determined to get coverage and want to pursue it I guess I would start with a lot of research on the procedure, get a letter of necessity from a doctor and write them a letter with the cost of surgery and the cost of this procedure, everything you have tried to get rid of PF, the cost that will continue to incur if you have to keep going to the doc at their expense etc etc etc.

Re: Insurance Coverage for Shock Therapy

Dr. Zuckerman on 8/21/01 at 17:55 (057470)

Give the people at healthronics a call. I was told that there
have been some insurance coverage with the blue shields in
Illinois.
I have been able to make some deals with one NJ Blue Shield called the
devon plan.

Was very surprise. But did do it .