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HEALTH PLANS: Patient activism using the web

So I was sent an appeal by a grandmother upset that her grand-son was denied surgery by his insurer for what looks to be a pretty unpleasant condition, called Pectus Excavatum.  She has taken the campaign to the web.  I can’t comment on this particular case or the surgery in general, other than to say that if it was my kid, I’d want the surgery done too.  But this is a wave of things to come.

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Guest

Awesome write-up, I am a huge believer in placing comments on weblogs to allow your blog editors know they’ve created something of value to the web!

CA
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CA

I am looking for legal advice re: fighting insurance denial for artificial disc replacement under New York State insurance law on the grounds of experimentality. I have had more surgeons than I can count tell me that given my current spine configuration, the fusion that insurance would pay for would result in a lifetime of disability. If I receive ADR surgery, I have a 90% chance of a normal life, again, given my condition and circumstance. Catch this: the ADR surgery would actually be CHEAPER AND comes with better results. Any ideas? I can’t afford to pay for surgery out… Read more »

CA
Guest
CA

I am looking for legal advice re: fighting insurance denial for artificial disc replacement under New York State insurance law on the grounds of experimentality. I have had more surgeons than I can count tell me that given my current spine configuration, the fusion that insurance would pay for would result in a lifetime of disability. If I receive ADR surgery, I have a 90% chance of a normal life, again, given my condition and circumstance. Catch this: the ADR surgery would actually be CHEAPER AND comes with better results. Any ideas? I can’t afford to pay for surgery out… Read more »

CA
Guest
CA

I am looking for legal advice re: fighting insurance denial for artificial disc replacement under New York State insurance law on the grounds of experimentality. I have had more surgeons than I can count tell me that given my current spine configuration, the fusion that insurance would pay for would result in a lifetime of disability. If I receive ADR surgery, I have a 90% chance of a normal life, again, given my condition and circumstance. Catch this: the ADR surgery would actually be CHEAPER AND comes with better results. Any ideas? I can’t afford to pay for surgery out… Read more »

M Millard
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M Millard

Hey North Carolinians! I just discovered a big thing BCBS is not telling people. As we are mostly part of the boomer generation I had found out that BCBS pays for colon cancver screening if you are 50 or over. One HUGE caveat! If you get it done at a hospital (which I assumed you had to do) you get a huge bill because as surgery it goes toward your deductible. If I had gone to an outpatient center like a phyicians office or an Endoscopic facility all I have to pay is my COPAY. Boy did I feel ripped… Read more »

Science of beauty products
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Blog2read – Go to Blog Search Home. Web Images Video News Maps more » Close menu Blogs …Advanced Blog Search · Preferences. Find blogs onyour favorite topics.
Create your own blog and let us promote your post. We arranged blogs and its categories for you to submit post the the relevant blog and its category.
http://www.miniweblink.com/30v2

Steven D Landis
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Steven D Landis

M-Care has retracted their refusal to cover our son’s issue. I would like to thank our doctors, and their staff for their efforts that resulted in reversal of the original decision. Surgery is scheduled for Dec. 27th.
sdl

Steven D Landis
Guest
Steven D Landis

Hello, My 14 year old son is also afflicted with pectus carinatum. After examination, surgery was scheduled at Mott Childrens Hospital, Ann Arbor Michigan. We have also run into a similar refusal by our insurance company, M-Care, to cover “cosmetic surgery” by their determination. We do not consider this to be cosmetic, but rather a deformity, and therefore insurable. Our son not only has become self-conscious of the condition, and has withdrawn from many activities normal for an active teen. He participates in most school sports, has extraordinary athletic ability, but is hampered by limited breathing recovery. We have appealed… Read more »

Kandy
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Kandy

My son also has Pectus Excavatum. He is 14 years old and it’s effecting him terribly. Mostly mentally. He wears heavy jacket’s to school so kids won’t tease him and it will be 90 degrees out. We have Kaiser and I’ve taken him to see his doctor who wouldn’t give us a referral to see a surgeon. After some research online I noticed Kaiser does offer this surgery. Has anyone gotten approved for this surgery that has Kaiser??
Thanks!

Mike
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Mike

My daughter has just been turned down for pectus excavatum surgery by Health America ?
Does anyone have any advice on how I might successfully appeal this ?
Thank You !

Sherry
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Sherry

Dear Grandma Dee,
What is your e mail my son needs the same surgery your grandson had. I need to write to you. Kindest Regards, Sherry

D.R.
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D.R.

I was just denied corrective surgery for Pectus Excavatum by BCBS. They claimed that my surgery was simply for cosmetic reasons also. I have had a CT scan done as well as breathing tests that prove that my lungs and heart are being constricted by my condition. I am in the middle of filing an appeal with BCBS. I hope to be approved for surgery.

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gadfly
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gadfly

To which I say: universal coverage.

Ron Greiner
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Ron Greiner

gadfly, The first 7-11 owner that enrolled in an MSA in January 1997 did have a heart attack. I took him off a small group plan. So, he can now sell his business if he wants too. Also, he followed the doc’s advice and his premium plummetted because he quit smoking. He and his wife are about 55 years old now and his premiums just went over $300/month this year. The 7-11 newsletter reported he saved over $7,000 a year in premiums way back then when he still smoked. Here is another small group plan question if you want to… Read more »