Mar 08 2008
Frustration with BCBS insurance denial
Today I learned that my insurance company, Blue Cross Blue Shield of Michigan, denied my request for a medial meniscus transplant for the third time. The first two attempts were done via letter and the most recent attempt was a half hour in-person conference on February 14th. They apparently sent a letter the first weekend of spring break notifying me that they decided to deny my request once again. My mom and dad decided not to tell me until today when I stopped by my parent’s house on my way back to Ann Arbor from working in Detroit.
My parents gave me the three paged letter saying that I was denied again and that I had two more options: appeal to an external insurance board or a civil lawsuit. We don’t know which step we will be taking next as we want to make sure that if we appeal to the board, that won’t eliminate the option to file a civil lawsuit if I’m denied once again.
I don’t think I’ve ever felt this blessed and disappointed at the same time before. This morning, I had an absolutely amazing day at work and got to do some things no other Red Wings interns had gotten to do yet this year and I was in such a fantastic mood. I have been blessed with the gift of an internship that I absolutely love. But I’ve also been blessed with amazing family. My parents told me that they would do whatever it takes to get this surgery whether it’s appealing to the external board review, filing a civil lawsuit, or paying for the surgery themselves if all that falls through and my dad said he’d even be willing to sell his beloved ‘63 Corvette to help pay for my surgery (now that’s love!).
If my family ends up having to pay for it, money will be incredibly tight and we will all have to make some sacrifices. But I’m 21 years old with arthritis. I can’t stand or walk without pain. And biking, swimming, and using the elliptical are completely out of the question. If the other avenues fall through, I would have to wait 20+ years before I would be old enough for a knee replacement. And that’s why my parents are willing to make huge financial sacrifices to pay for that surgery. Hopefully, it will not get to that point because I don’t want to be a strain on my family and their budget.
Between the support of my family and all of my friends (including the many of you have sent words of support over the last month), I feel so incredibly blessed. At the same time, I feel so disappointed. It has been a very emotionally draining experience and it has now been almost four years since I first knew I needed this operation. I want so badly to be able to walk and stand with little to no pain that it is disappointing when you see insurance deny you this request three times. But I know that God has a wonderful plan for me so I will choose to focus on the blessings in my life rather than the disappointments.
“I will praise You in this storm…”
- Casting Crowns
I’m also 21.. but haven’t been diagnosed with anything. I do believe, however, that I do have arthritis and weak joints. It could be from my previous job as a housekeeper which lasted only a few months because my body couldn’t take the bending anymore. But now I work in a factory and if your job at the time is screwing caps and tops onto bottles.. then.. that is a real pain, too. (also packaging.. lifting all those bottles for hours on end)..
I was just wondering how you deal with your pain.. medication? if so, what kinds? And do you perform specific exercises to help build strength in your joints?
I was thinking of trying this pill called Flexcerin.. and I also saw something on TV called …oh the name escapes me right now.. but it has Glucosamine and Chondroitin that help your joints.
Just wanted to say something to let you know you’re not alone.. it sucks that we have to go through this already.
Hi Emily!
I have been taking Vicodin daily since 2003 and my pain medication intake is monitored monthly by my pain specialist. I do some physical therapy type exercises to help strengthen my quads, but I can’t do any kind of cardio for the lower body.
I haven’t taken any of those Glucosamine and Chondroitin pills because studies have shown it really doesn’t help and I don’t want to waste money. :)
Thanks for the encouragement and I hope you feel better too!