u/Accx4

Facing a situation with the VA where they will not cover a procedure (nevro hfx spinal cord implant unless it is placed by pain management however the permanent implant with the paddle leads requires an orthopedic surgeon to do the bone work) The VA also wants to forward me to a pain management doc that can do the paddle implant but with a system I do not want and will not consider due to differences in historical results and technical function of the device. IF i choose to jump over to Medicare, i can continue with my same care team (adding an orthopedic surgeon). My cost share is 20% and I have no idea what that will cost but at least I get what I need.

Anyone have VA and use medicare for certain things the VA wont? What has your experience been? Any information is appreciated!

Had my trial implant done April 8th resulting in success. Today I get a call that the surgeon my pain management doc referred me to cannot do the procedure because he is an orthopedic surgeon and not pain management. My pain management doc cant install the paddle as there are ortho procedure that have to be done to attach the paddle to my spine. As well, they can get me into a surgeon at a different health organization that installs a completely different implant from a different manufacturer. This is unacceptable to me. I WILL NOT have percutaneous leads for long term due to migration issues and i will not have anything less than the Nevro HFX because it does its job without the tingle that stimulators produce.

Does anyone know if Medicare covers Nevro's HFX with paddle? It is looking like if i went that route i could keep he same med group that did my trial, has all my records, etc.jJust another great disappointment from the United States Veterans Affairs...