Before you do a neurostimulator trial PLEASE READ

Question

I found out today, 2.5 months after my neurostim trial that you need to CHECK YOUR INSURANCE. Part of the claim is for "medical equipment"

The doctors office filed it for $13,000. The insurance reduced it to &7,000 and some change and apparently I'm responsible for 30% of "medical equipmet" yeah, the part that ends up in the trash. It's costing me just shy of $2,000 out of pocket. I'm learning the hard way... PLEASE KEEP THIS IN MIND

pammyp54 · Answer

you are lucky, my doctor billed over 200K which my piece is only 1250 but the shots were costing more so I am glad I got it. It has made a huge differece and since I am not eligible for another back surgery, it is a real plus

Heidilly · Answer

Thank you so much! I'm starting the process right now for a neurostim trial. I couldn't have read this at a more perfect time.

bigfootj33 · Answer

Pain Management. I had the neurostimulator trial. This was to be a trial and my insurance would pay all except for a $12.00 copay. Not true. They billed tricare almost $21,000. Tricare paid them over $6,000 and I had to pay $1271.93.
Outrageous!

atonicat · Answer

Your total cost will depend on how your doctor bills the insurance. They will probably bill it as surgery, so you'll have to find out what your co pay is for surgery. There may be a different co pay for having it in a hospital vs. in a doctors office. Then they will bill for "supplies" which will be the things like needles, IV's, medication and so on. Then there is the equipment co pay. For example, this is how my doctor billed my insurance after I had radio frequency ablation:

2/4/2011  	 SUPPLIES performed at Hospital outpatient/surgicenter  	 $5,670.00

They billed that same line four times for the same procedure because they burned at four different levels. So the final cost was over 22 thousand dollars. I had this procedure done twice so it would have been 44+ thousand dollars out of my pocket. And I have no idea how they can bill it as supplies. I had to pay $150 which is my co pay for outpatient surgery. I don't have a deductible with my insurance so I'm not sure how it works. 

With my insurance they would pay the full amount of the surgery to get the stimulator (less my $800 copay because it would probably be in a hospital) And they would pay 30% of the cost of the equipment. So if you have one co pay for surgery that includes the cost of supplies, than I would find out what you insurance would pay for the equipment. That should give you a realistic idea of how much it will cost.

tina17522 · Answer

Gee, there is a wealth of information on this site,  I am scheduled for a trial next Tuesday and now need to call and find out what costs I will be paying out of pocket.  Thanks for posting this on an old blog.

markemsu · Answer

An old posting, but I'll try anyway. I'm also facing the dilemma of coinsurance costs for neurostimulator costs. I could not get even a ballpark amount from the doctor/hospital or my insurance co. The coordinator was only able to give the costs for the doctor fees. Hospital and anesthesia would be undetermined costs. Your post gave me the lightbulb that the equipment would also be another cost consideration.
Your $2000 figure, I reading that was only the line listing for your med equip costs. What are the costs for remainder? I also have a 30% co-pay after a $3500 deductible.

designgyrl · Answer

I'm glad you posted this.  I'm in the middle of them trying to schedule a neuro trial and it may be something that I also can't afford especially with the amount of medical bills I've had recently with being in the hospital twice and the ER twice.  I normally have to pay 20% so I'm thinking I may want to rethink this decision at this time.

runitskat · Answer

I just looked at my cost for a SCS and it's 50%. So I really doubt I could afford it. Plus I'd have to pay for the actual surgery which could be between $150-$800 depending on how they classify it. Each injection I had was considered "surgery" by my insurance and cost $150 each! That's just crazy.

JadedSweetheart · Answer

Oh, disreguard my question on your other thread!  I was always under the impression that the neurostim trials were like a medical research thing so they paid all the costs.  I'm glad to know what it's really about.  
Like RunningMom, I am worried about scar tissue from the placement and the leads.  It seems like it's not worth it for a possible reduction in pain.  If it was a sure thing then I might be more for it.  No doctor has ever suggested it to me, though.  
Thanks for letting us know about this, Dont.

RunningMom · Answer

This is the only thing my insurance will possibly not cover.  I would not know until I had the trial and submitted the claim.  I would have to pay 20% of the trial only.  That is one of the silliest things I've heard.  I checked this out a while back.  It's always smart to check every procedure as well with your insurance before going ahead and doing it.  The clinics most likely will not do this for you.  I could never afford this either, especially with ONLY a 50-70% of a 50% pain reduction.

Very good post.  Thank you for the heads up for anyone who is considering this as an option.  I'm so sorry this happened to you.

I personally never want the SCS.  This is the only procedure I've turned down.  I do not want this in my spine possibly causing un-needed scar tissue from the leads that are placed.

Tuckamore · Answer

Thank you for sharing your difficult lesson with us. You are so correct. We don' always check with our insurance gods and can have some costly surprises. 

I am so very sorry that this has happened to you. But I want to thank you for sharing this with us. Maybe it will save someone from learning the hard way.

 Peace,
~Tuck

runitskat · Answer

I meant to say $100 a month on doctor visits and prescriptions.

runitskat · Answer

I just found out today that I have to pay for 50% of my TENS unit. It's only $150 but I just go done paying off the $450 the injections cost me. There is no way in hell I could afford $2,000. I already spend about $100 on doctor related things (appointments and medicine) I make enough to pay my bills and give me about $200 for 2 weeks to live on so it would take me years to pay $2,000 off. And knowing my insurance it would be a lot more. Thank you for letting us know.