Question:
Denied by BCBSNC because my blood pressure has been controlled thru meds, Help?

How should I proceed? I cannot stop taking my meds and die to qualify. Has anybody else had this problem?    — Kareba (posted on October 24, 2009)

October 24, 2009
That seems absolutely ridiculous to me! I am so sorry to hear that they are jerking you around like this. :( It sounds to me like they are just trying to stall and make you give up because you get too frustrated to fight for it. I think I would talk to my primary care physician and develop a strategy for dealing with meeting their criteria. Hang in there...and DO NOT give up! It is so worth the fight!
   — PaulaJ

October 24, 2009
Have you had several changes with the dosing of your medication. If so have your PCP report that, there are adverse reactions to constant increase or decrease of medications.
   — bldeck

October 24, 2009
Don't give up, I was also denied, I think everyone gets denied at least once, have your Dr. send them a letter! This is their way of discouraging you. Many people have medicine controlled bp, the weight loss is what helps you get off the meds. Keep hangin' in and stay strong!!
   — aliclaire

October 24, 2009
Ten years ago I was denied the first time by BSBC also - my dr's appealed the insurance company's decision for me! Don't give up, ask them for help. Good Luck!
   — Pamela Ryan

October 25, 2009
I was schedule for the band 2 weeks ago & 1 week before BC denied me. The dr appealed & didn't win. My dr spoke to a dr there but perhaps he was a podiatrist..lol. They are not surgeons. It got rejected 2x in the week, the 2nd time the friday before my Monday surgery. I thought the world was coming to an end. I appealed it myself & sent in all documentation & won. Had surgery 1 week ago. The 2nd appeal I put in was looked at by a SURGEON! Don't give up, appeal, etc. They want you to give up. Also if you work for large co or have a union they can intercept and help you. THey often have a liason. Write a letter in your own words. Use height, weight, bmi, medical issues, etc. If they get tired of you, they will approve it! If you need addtl help, email me. Don't back down!
   — Linda R.

October 25, 2009
oh and also the biggest reason they denied me, was I was banded before & had to have emergency surgery 3 months ago to remove. No fault of my own! I had done well w/the band prior. GOOD LUCK
   — Linda R.

October 26, 2009
Karen, health insurance companies are out to make money. The more they deny, the more money they make. Sometimes the doctors who work for them make money based on the number of denials they give. Don't give up. Their just trying to make you noe fight for what you deserve.
   — Muggs

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