I've found that most all insurance companies cover GRS when it's proved as being a medical necessity through recommendations from therapists, etc. However, their clarity and what I'd then think ease of actually getting it covered differs.
It seems most if not all surgeons (at least here in the US) don't accept direct coverage. So insurance coverage would then only be possible via reimbursement which could then be tricky to coordinate between the company.
One of my peers who got surgery from the same surgeon I have a consultation with got their GRS covered by United Healthcare via reimbursement. I've seen they have extensive information, and I'd assume then familiarity and understanding, about GRS coverage. Aetna also seems to have clear and concise information. However, these companies don't offer plans to individuals and my employer doesn't offer either of these plans.
I'm eligible for TriCare for example, but after speaking with them for a while and explaining the situation, even higher up support were unsure about stuff, which then makes me uneasy about what might happen when I'm actually going through the reimbursement process. I also spoke to BC/BS who said it would have to go through an exception type process.
Does anyone have experience with individual plans where you were either able to successfully secure reimbursement for your GRS, or have some sort of confirmation or dialog with a representative that was familiar with it and it indeed being possible? Or maybe some advice on how to go about the insurance aspect of GRS coverage?
