Any luck getting insurance to pay for prolotherapy?Posted on 05/18/10, 10:39 am
I am going to move forward with prolotherapy. Has anyone had any luck with getting insurance to cover it? If so, which insurance and how did you go about it? My insurance is Cigna.
I really appreciate your input.
Reply #1 05/19/10 1:59pm
My insurance does not pay for it. The treatments can be expensive especially the prp, but it is well worth it. I just had a treatment yesterday to my hip ligaments, ischial tuberosity, and glut muscles. I am very!!!! sore today, but hopeful it will get better in the next few days. My prolo Dr. will only do one big area at a time, and uses xray and that is an added expense, but at least I know she is getting to the right areas. In my experience, you will probably need more than one area treated. When you have instability, it is usually in more than one area.
What areas are you having treated? I had my sijoints, lumbra area, pubic symphysis, and hips treated. I think that is where most people have pelvic instability. Good Luck and keep me posted. Sharon
Reply #2 05/19/10 2:19pm
Thanks for your response. If anything, I have to my advantage a letter for the Pain Clinic at the Mayo Clinic in Rochester that recommends me for prolotherapy. But I am counting on coming out of pocket for it.
I have made some calls to local providers. It scares me that they don't use fluoroscopic x-ray...like you say, I want to know that the know they are hitting me in the right spot. My doctor has recommended injecting all the sacroiliac ligaments in several spots.
I did see a video that showed treatment of the lumbar spine ligaments as well for sacroiliac pain. It looked like well over 20 injections all at the same time without x-ray. That scared me too, especially with the nerves involved with the lumbar spine.
I am tempted to go to the Mayo Clinic every time all though I am very far way (in Las Vegas) just because I trust what they do. Just curious, how much do you pay for your injections?
Reply #3 05/20/10 4:54pm
I pay $550 per area for the prolo and $850 for the PRP. I am hoping to be able to write it off for medical expense on my income taxes. There is a really good Dr. in Salt Lake City and I believe he uses ultrasound, which is also good. One of the girls in this support group used him. It is a real slow process, and it may take many treatments. It is the only treatment I know that works for weak ligaments!!!! I will go back to my Dr. in about 6 weeks for her to reassest my areas, and to see if I need any more treatments to the various areas. Good Luck!!! Sharon
Reply #4 05/20/10 6:27pm
Do you know the name of the doctor in Salt Lake that uses ultra sound? It may be an option.
Reply #5 05/25/10 4:27pm
Just saw this and will add my two cents. I went round after round of appeals with Cigna trying to get them to pay for prolo. Finally went to arbitration - they ruled against it, since no other ins. company pays either. You can try, but I went all the way through the process with no luck. Pricing for me (my doc is in Wash DC) is very similar to Sharon's. She's right - it is absolutely worth the expense. I am more severe than most, so have not had total restoration, but it definitely brought me back from insanity due to incredible pain. Now still have pain, but at least tolerable. Best wishes - you are on the right track. Consider using a girdle or SI joint belt worn low over hips at the same time - it does add stability.
Reply #6 05/26/10 2:34pm
Well, I wouldn't count on getting anything paid from Cigna then. Thanks for your input!
Welcome! This group is for those of us suffering from musculoskeletal pain resulting from an instability in components of the pelvis, including the sacroiliac joints, pubic symphysis, or hips. This can be caused by trauma to the bones or soft tissues of the pelvis, hormonal changes, or hypermobility of the joints of the pelvis. Pelvic instability can be acute or chronic. It can be mildly irritating or extremely painful and debilitating. Whatever your situation, you're in the right place