I bite my thumb at thee, Medicare
Medicare, as far as I'm convinced, has some idiots on their staff. My stepmom has been waiting for approval for her gastric bypass surgery so that she doesn't have to be dependent on the insulin shots which are slowly killing her. Also, she takes 37 prescription medications to treat her Diabetes and Graves Disease. However, an RN (not a doctor, mind you) from Medicare denied her coverage on the gastric bypass surgery because they felt that she was "doing it for cosmetic reasons". (for those of you who aren't familiar, gastric bypass is basically a shrinking of the stomach that is the only known "cure" for Type 2 diabetes and it solves other problems brought on by obesity).
So...if she doesn't get the appeal this week, then she's fucked for having surgery. This surgery was recommended by a doctor, and after a year of testing, was still suggested, but a nurse had the power to decide that it wasn't for the right reasons. I'm sure they have a lot of bullshit cases, but they are making a huge mistake with this one. If the appeal doesn't go through...some big shit will definitely hit the fan. I respect nurses in their profession and all, but they are not capable of making such a decision, especially in light of a doctor's recommendation. Anyone, trained or untrained, who actually LOOKS at my stepmom's medical records would determine that the surgery is NOT for cosmetic purposes.
So...if she doesn't get the appeal this week, then she's fucked for having surgery. This surgery was recommended by a doctor, and after a year of testing, was still suggested, but a nurse had the power to decide that it wasn't for the right reasons. I'm sure they have a lot of bullshit cases, but they are making a huge mistake with this one. If the appeal doesn't go through...some big shit will definitely hit the fan. I respect nurses in their profession and all, but they are not capable of making such a decision, especially in light of a doctor's recommendation. Anyone, trained or untrained, who actually LOOKS at my stepmom's medical records would determine that the surgery is NOT for cosmetic purposes.