[LIT LOVE]

I'm on SSDI with an active WC claim in Cali. I also have Medicare with Supplemental Insurance, but this is a work injury.

If anyone has had success with WC in CA for Ketamine procedures, I'd appreciate hearing your story. I'm trying to get WC to approve an SCS trial, but if Ketamine is a viable option, I'd rather attempt it first.

I'm willing to travel or even relocate ANYWHERE. If my only option is Out of Pocket, what are the real costs?

[Reddawn600]

Originally Posted by LIT LOVE

I'm on SSDI with an active WC claim in Cali. I also have Medicare with Supplemental Insurance, but this is a work injury.

If anyone has had success with WC in CA for Ketamine procedures, I'd appreciate hearing your story. I'm trying to get WC to approve an SCS trial, but if Ketamine is a viable option, I'd rather attempt it first.

I'm willing to travel or even relocate ANYWHERE. If my only option is Out of Pocket, what are the real costs?

Hi, I'm a bit unsure if you're referring to out of pocket Ketamine costs but that's what I'm assuming so will try to help you out. I can only really answer for what I've paid and heard others pay from what is written in the forums.

A lot of insurance companies now cover inpatient treatment programs. Mine did for a five day program and my out of pocket was less then $1,000 including the doctor's bill.

I have heard of others whose insurance companies denied it and they paid up to $40,000 out of pocket.

For out patient infusions, the rates seem to be between $400-$2,000 per treatment depending on the doctor.

I can say from personal experience that the higher cost most definitely does not make a difference in the quality of care in this case. For some reason, the rates just vary wildly,

Hope that helps and good luck,
Dawn

[LIT LOVE]

[QUOTE=
I can say from personal experience that the higher cost most definitely does not make a difference in the quality of care in this case. For some reason, the rates just vary wildly,

Hope that helps and good luck,
Dawn[/QUOTE]

Sorry this was confusing, Dawn!

Thanks, knowing that the rates run between $400-2000 for outpatient treatment was what I needed.

I had picked up on that the rates fluctuated, but I was unsure of the range. For me, if my only choice is to go out of pocket, it makes sense to seek out that lower cost, same quality care, and travel or relocate there.

I had a consult with Prager at UCLA for Ketamine, and he advised a (WC paid) SCS month long inpatient program. For Ketamine, it would have to be Out of Pocket, and the figure quoted (inpatient only) was so out of reach possibilty wise, I gave up hope and have been pursuing approval for a SCS trial.

I'll read up on outpatient Ketamine treatment. That seems like a viable option.

[smile357]

Please try ketamine before SCS. It is a very difficult surgury. Talk to people who have the SCS and really think about it before getting it implanted.

[ballerina]

Please make sure you do your home work before opting for SCS. There is a very real possibility that you will end up worse than you are now.

[LIT LOVE]

The SCS issue has been a consideration on and off for 6 years.

I've gotten up my nerve to move forward and then had WC play games with the approval for the trial.

4 years ago I underwent pysch testing for the trial.

Pysch doc gave his approval.

WC stated that the time period for me to have had the SCS consult had lapsed days after I got the report of approval from the pysch doc. They never gave notice they had approved a consult.

We went back and forth for monthes, and at some point I lost my nerve because of reading yet more horror stories about the SCS.

After years of requests and denials, WC finally gave approval for me to see an RSD specialist. I saw Praeger earlier this year. When his office tried to get the SCS trial approval, WC claimed I never followed through with the original pysch testing 4 years ago, so they were calling time lapse foul... They paid a couple of grand for the darn thing!

So, I raised my concerns about the SCS with Praeger and he eased my fears, but without question, I'd prefer to attempt Ketamine first.

I'm in the middle of finishing up another round of pysch testing for the SCS (another delay tactic. Same doc that did approval 4 years. And he already signed an updated approval.) So, I have some time to research this.

My treating doc would prefer I try Ketamine instead of the SCS, as well.

I'd love to hear from anyone:
That's had WC approval for Ketamine in CA!
Had out patient Ketamine treatment in CA!
Had high quality, low cost, out of pocket, out patient Ketamine treatment!

Thanks Again!