The Big Elephant In The Room
Does Insurance Cover It?
Let’s look at how we make our procedures available to everybody. Even people whose insurance won’t cover it, and how they can still get their lives back despite insurance.
The question everybody wants to know is, why doesn’t insurance cover the procedures that you do? Everyone needs to understand that Medicare has a rule, or law, that says if you do anything to improve health or quality of life, it’s considered maintenance care and it’s not considered medically necessary.
What We Do Improves Health And Quality Of Life.
This means Medicare covers nothing that improves health or quality of life. What we do improves health and quality of life. That’s another reason Medicare won’t pay for this.
I want you all to understand; I take this seriously. In fact, I traveled to Washington DC many years, and I spoke with our Montana senator at the time, Senator Max Baucus, who was the head of finance committee. This is the committee that oversees Medicare. We specifically asked him, why doesn’t Medicare cover procedures that improve health or quality of life?
His response was, “We’re not going to talk about that. Let’s move on to the next subject.” So as crazy as that may sound, that’s the law. Medicare doesn’t pay for anything that improves health or quality of life, and here at Joint Repair, that is what we do.
Healthcare Is Moving In The Right Direction
I’m so glad though that the prices have come down. From my understanding, people used to have to leave the U.S. to go to other countries to get the procedures done that we do here in the U.S. They paid upwards of hundreds of thousands of dollars for the same treatments that we do now for just a few thousand dollars.
The good news is we’re moving in the right directions as far as making this available for all of you out there. If you have been listening to me, and maybe have heard some of my other videos or comments, you may think I’m opposed to insurance companies and surgeries a hundred percent.
I want to clarify that I thank God for emergency medicine.There’s a time and a place for surgery and I am very grateful when a soldier loses a limb that we have artificial limbs to help them out. I want to make sure that it’s understood that I’m thankful for hospitals and medical doctors and joint replacement surgery in some circumstances.
I also want to make it clear, I think people should always try to find a healthy way to get their joints working better first and try every other option first. Then if that surgery is the only option left, and it gets people success, hallelujah. But I also know that we’d be inaccurate to think that every person who gets their joint replaced is happy because I’ve met way too many people that wish they would’ve tried something else first.
Surgery is very invasive and comes with risks. One blessing that we’ve had available is we actually had a patient named Rob who did the ideal research for us. He put his body on the line. He had joint replacement in one knee and he did human umbilical cord tissue in his other knee. We have the unique circumstance all within the same year to compare head to head. In Rob’s words, he said, “I wished I would’ve been more patient, and I wished I would’ve done umbilical cord tissue in both joints.”
Now, understand, in Rob’s situation, his insurance paid for his joint replacement. They didn’t pay for his human umbilical cord tissue injections and the re-cushioning in his knees. Even though his insurance didn’t cover it, and he had to pay out of pocket for the umbilical cord tissue in his knee, Rob still wishes he would’ve done that in both knees instead of having a joint replacement in the one knee.
It’s nice to know there are people from Montana that have compared one system to the other. And they chose what we do in this office as their preference and what they would recommend to you all. One thing I want to make sure you all understand, in Rob’s example, is they actually wanted to replace both of his knees. His doctors felt that both of his knees were equally bad. They recommended he replace both at the same time, but something in Rob told him he didn’t want to do that. He chose just to do one. And then he put the human umbilical cord tissue in his other knee.
After he did the umbilical cord tissue, he chose not to tell his doctors that he did the umbilical cord tissue in his knees. When he went back for his follow up appointment for his knee replacement knee, he asked the doctors that had examined his other knee and recommended replacement in his other knee.
Rob said, “Hey, while I’m here getting my appointment for my post-surgery, can you guys just check my other knee and tell me what you think?” They put him through the same test that they had done prior to his knee. After they got done with all the tests, they said, “I don’t know what’s going on, but this other knee seems to be doing really well.”
The cool thing is, at that point, he informed the doctor that he had done human umbilical cord tissue injections and he educated the doctors on some benefits of it.
To sum this up, and as hard as it may be to accept, our current reality is that insurance doesn’t cover what we do in our office. Hopefully, you can find enough drive or passion for your life to get better. Because ultimately, this, for me, isn’t about joint pain. It isn’t about joint function. It’s mainly about people being able to do the things they love in life and be able to enjoy life till the day they die.
If you can really put your focus on the value of enjoying life, getting better, not being a burden on your children, enjoying those grandkids, and enjoying your friends till the day you die, if you really focus on that, I think the price of the procedures we do, and if you put them in perspective, this is going to be something that you’re going to be glad you did.
It should drive you to set up a consultation with us to get the images done so we can do a thorough analysis of the best way to get you the best results that you deserve.