Need Tennessee help

Hi I'm Yvonne McCarthy from the Texas board. I left a message one day on Dr. Phil's board and a lady contacted me that needs help. I told her about the board and told her to join and post. I don't know how long it will take for her to post but anyone that could give me any info....it would be so appreciated. Apparently she has Blue Cross and has been denied? She has lymphedema and has had horrible infections. Is there someone she can get a consult with that can help her? Does anyone know about Blue Cross? This is her first email. Hello, I read your post on the Dr Phil site. and I have medical issues that 2 different doctors have said I need to have the gastric surgery. But my insurance company does not cover it. My doctor has even had one on one call with the medical director at Blue Cross Blue Shield and they still refuse to cover the surgery. Regarless that it is medically needed. I see that you were able to get your insuracne to cover it. Please tell me how. I do so appreciate your help. She sent me pictures and the lymphedema is bad. Any help would be appreciated. She has a special needs daughter and a son in Iraq. Thanks Tennessee!!

Hi Yovonne, Here is her post. Her name is Alice Neff. (alicem's) Her post is on the TN board a few down from yours. Good luck, Ellen I am new to the site. I have to have gastric surgery. But my insurance claims they do not cover it.My doctor has had one on one meetings with the medical director for BC/BS to no avail. Medical records have more then proven the medical need of my having the surgery. Besides I have a 20 year old special needs daughter, who I am the sole care giver for. She was a 3 month premiee at birth and has had 78 surgeries.She has many medical issues and behavior issues. There is no one at all who will watch her, because she has sever issues with self abuse. A nurse even left her alone because of it. I have to be around to care for her, and my own medical issues continue to get worse and worse, because of my weight. If I am not around, my daughter would be placed in a **home** where she would be drugged to keep her from hurting herself and or others. But then she would be a zoombie. And what kind of life is that???NONE!! And one she should not have to live. I have no way of affording to pay for the gastric surgery,I have sleep apena and I have lymphedema in both legs,have had 4 hernia repairs, that the last one the doctor told me if it had to occur again would be a major major surgery. Have been in the hospital 4 times for my legs, and once for a part of my kidney dying off from a blood clot. My insurance will pay for all these hospital visits and continue to pay for them, but will not pay for gastric bypass.These hospital visits have all occured within the past 2 years. I have tried so many diets so many exercise programs to no avail. please help someone. I am desperate!!

Sorry, I mis-spelled your name. Ellen

Ellen could contact the HR department where she gets the Blue Cross insurance., They may be able to helkp her with loopholes. There are simply some insurances that will NOT pay regardless of what the reason is. She may go to obesitylaw.com and get soe help there...

A little over a year ago, someone else out of Knoxville took Blue Cross to court because of the major need for the surgery. She was like this other lady with the special needs child. She sued Blue Cross because they put an exclution about the surgery in their policy. The judge ordered the company after looking at all her medical problems because of the weight and all the letters from her Dr.'s and made the company pay 100% for her to have surgery. Blue Cross sure wants your money for the premiums, but they don't want to help out much in paying for your medical costs. Even my parents are having a hard time with their Blue Cross from where they retired from. Maybe this info will help her to be able to have the surgery, not just for her health but so that she will be able to continue taking care of her daughter. I'll keep Alice in my prayers. Love Kathy