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Author Topic: URGENT - Trochleoplasty and AXA PPP - they won't cover me!!  (Read 1405 times)

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Offline veganbee

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URGENT - Trochleoplasty and AXA PPP - they won't cover me!!
« on: August 16, 2012, 02:09:00 PM »
After receiving a letter saying they 'promise' to pay all my costs, AXA hae just informed me that they will not pay for my trochleoplasty as its too experimental! (I'm in the UK)

Urgently need you wonderful people to let me know if you've been covered by AXA PPP for a trochleoplasty, and any info you think might be useful to me in convincing them that it's NOT experimental (e.g. its been done on the NHS for at least 5 years as far as I know!)

Absolutely gutted as I am going to have to find some source of funding for the op if they won't pay for it :( and I'm skint enough as it is! Can't believe it, feels like the bottom's fallen out of my world right now!

Offline Vickster

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Re: URGENT - Trochleoplasty and AXA PPP - they won't cover me!!
« Reply #1 on: August 16, 2012, 07:33:56 PM »
Have you spoken to your surgeon or at least his secretary as to whether he has done these privately before and which companies covered?  Sometimes you need to show a precedent.  Alternatively, if it's been done on the NHS for 5 years, can you transfer to the surgeon's NHS practice - if he has one?  Or is there another surgeon who could do on NHS?  Which hospital were you going to be going to?

I had lots of battles with another company a couple of years back - utter pain, but the secretaries are used to deal with the companies.

Good luck :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Lottiefox

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Re: URGENT - Trochleoplasty and AXA PPP - they won't cover me!!
« Reply #2 on: August 16, 2012, 07:39:34 PM »
Thanks Vicks - I knew you had insurer experience and cited you in another post!  :P ;D
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Offline Vickster

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Re: URGENT - Trochleoplasty and AXA PPP - they won't cover me!!
« Reply #3 on: August 16, 2012, 07:44:32 PM »
Yep and have responded!  ;D
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline veganbee

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Re: URGENT - Trochleoplasty and AXA PPP - they won't cover me!!
« Reply #4 on: August 17, 2012, 11:34:30 AM »
Thanks for your responses guys. It's no longer available on the NHS unfortunately as my OS only does private.

I have spoken to my OS's secretary this morning and she seems very keen to fight this which is promising! She said BUPA intl has paid the full costs in the past, and other insurance companies have at least contributed something towards the cost. I've also asked my employer to see if they can have any influence over the insurers as after all they do pay their fees!

I am going to Parkside Hospital in Wimbledon.

I'm hoping and wishing and praying that AXA will at least pay for the hospital stay, and I could pay the consultant's fees, but I'm not quite sure how these things work tbh!

Offline LauraB

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Re: URGENT - Trochleoplasty and AXA PPP - they won't cover me!!
« Reply #5 on: September 21, 2012, 02:34:27 PM »
I'm in exactly the same situation. My consultant has been doing the trochleoplasty for around 10 years for the NHS (in Cardiff, UK), he has done 37 of them and has had good results. Since I am a member of AXA health insurance through work I was hoping to get the procedure done as soon as possible. I found out today that the trochleoplasty is 'experimental' and so they won't cover it. I'd be interested to know what happens in your case!
1992 - First dislocation
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Offline westco

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Re: URGENT - Trochleoplasty and AXA PPP - they won't cover me!!
« Reply #6 on: April 10, 2017, 07:23:03 PM »
Can any of you tell me what happened with your insurance and coverage regarding this procedure?

I am in the same boat at the moment.

Any advice would be wonderful.  Thanks!