Insurance refuses to cover surgery

[sleepwalking]

I have neuropathy in my left arm and hand due to a ruptured disk in C4-5. My left hand is becoming paralyzed.The skin on my arm and hand sags where the muscle used to be. I am in constant pain. It is all I can do to make it through the day. According to the neurosurgeon I saw I am at risk of becoming qudraplegic as the disc is compressing my spinal cord.
Yet, my insurance carrier refuses to pay for the surgery. They claim she hasn't proven a medical need. Does anyone know who I can turn to for help? Is there a watchdog or agency that oversees such matters? At 51 years of age, I am far to young to be sidelined by a debilitating condition. I have a wife and kids who need me.

[BeHappy2]

Would probably be best to have a 2nd opinion from a neurosurgeon.
Then if 2 neurosurgeons have the same diagnosis that you need surgery


You can always file an appeal of decision with your insurance carrier.




Wish you well
BeHappy2

[SpineAZ]

Contact the insurance company and ask for a letter of denial that details the basis for the denial of the benefits AND for a copy of the exact plan under which you are covered. Also ask them for details on how to appeal. Often this must be done within 30 days of the denial. Then provide the denial letter to your physicians and ask for their assistance in appealing.

Often it's an error or omission on the part of the doctor's office where they may have provided minimal information or wrong medical diagnosis codes.

Before you can even consider going to your state department of insurance you must go through the appeals process.