[CarlaSB]

I am so sorry to learn of your insurance issue with BCBS. I am not sure if this strategy approach will help you in any way, but last year I had A-BC and my spine issues had gotten worse, so I went to see my spinal surgeon in San Francisco. He told me that I needed an ADR, but that BC would not approve it. He said they would most likely approve a fusion, given my history. Only a few insurance companies will pay for an ADR.

I know your situation involves a fusion, but here is what I did:

I asked the spine surgeon's staff for the names of insurance companies known to have approved and covered the surgery he was recommending. One insurance company mentioned was Cigna, which happens to be one option available to us under my husband's insurance coverage with his company.

So I thought, "Why couldn't I switch to Cigna when the enrollment period happens every year in October, then schedule my surgery when covered in 2011?" Since it is the same employer, there is no pre-existing clause.

That is what I did, and now my surgery is scheduled. It was hard waiting almost 6 months for the insurance changeover, but I didn't want to have to pay for this surgery out of pocket.

Obviously, this strategy is only successful if you work for a company that offers multiple choices for your health care coverage- and one of the companies will pay for your surgery. There are many variables depending on your employer and medical plan.

Good luck to you, I hope you will appeal.