Persuading insurance company to pay more for surgery?

I have a rare genetic condition, Ehlers-Danlos (EDS). I also have BCBS of Texas for insurance. I need a surgery which totals $25,000. I’m waiting to see how much BCBS will pay but I know it won’t come close to paying for the surgery. I’ve been in chronic pain for 8 years and have had many unnecessary surgeries, MRIs, CTs, injections, etc. Now that I finally have the correct diagnosis this surgery could, in the long term, save BCBS more much than the cost of the surgery.

Has anyone had success writing a letter to their insurance company and trying to persuade them to pay for most of, if not all of a procedure or surgery?

A lady flew from Iraq, with the same condition as mine, to see the surgeon I want to use and now is pain free. It seems short-sighted of an insurance company to not bend the rules on occasion if they were to gain financially in the long-term.

submitted by /u/dmjra
[link] [comments]
I have a rare genetic condition, Ehlers-Danlos (EDS). I also have BCBS of Texas for insurance. I need a surgery which totals $25,000. I’m waiting to see how much BCBS will pay but I know it won’t come close to paying for the surgery. I’ve been in chronic pain for 8 years and have had many unnecessary surgeries, MRIs, CTs, injections, etc. Now that I finally have the correct diagnosis this surgery could, in the long term, save BCBS more much than the cost of the surgery. Has anyone had success writing a letter to their insurance company and trying to persuade them to pay for most of, if not all of a procedure or surgery? A lady flew from Iraq, with the same condition as mine, to see the surgeon I want to use and now is pain free. It seems short-sighted of an insurance company to not bend the rules on occasion if they were to gain financially in the long-term.
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