> The stage that I am at now is that we have a tentative date set for
> April 16th in Manhattan. My insurance company said that I need to send
> them a letter from the surgeon at Hopkins stating that Dr. Redan is my
> only option. (He is a nice guy and does believe that I am in crippling
> pain, so hopefully he'll write it. Keep your fingers crossed!) Then
> their Review Board will make a ruling.
Make sure that you exhaust all your options. I believe in NY state you can get a review by the Commissioner of Insurance as well as your own insurance company. Ask for the entire appeals process to be spelled out for you -- which by law they must do.
Sometimes the insurance companies will pay for a procedure for an individual to avoid getting it kicked up higher and establishing a policy. This was true for several of my friends who asked Blue Cross to cover bone marrow transplants for breast cancer. The insurance paid, but did not establish policy so that they would have to pay for others. A fine point, but one that might help you get your surgery in PA paid for.
-- Kate Murphy email@example.com