I cannot believe this! I get a call this morning my insurance denied my transplant at UCLA. The lady said it had to do with my insurance.  I have Anthem Blue Cross CA and secondary Medicare? That isn't good enough? I am supposed to get a call from UCLA's finance dept.

I don't understand why we constantly have to fight for our rights causing grief and depression and who knows what else to a sick person. I feel beaten down and stepped on. I have to get my act together to figure out  my next step. I will. 

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  • Good news! A bit after the denial my outrage kicked in. I got the ball rolling calling everyone including Anthem blue cross asking why? No one had a good answer at first. Within a week Anthem Blue Cross approved a 2nd opinion. I talked the a coordinator at UCLA and she said don'worry about the 2nd opinion. I will see a doctor at UCLA the week of Sep. 9th.

    ow of course I am Nxious but ready. This is the 2nd transplant center. UCLA San Diego said I was high risk and my pulm needs to find an alternative meds and I should continue on with what lungs I have left. MY jaw dropped at UCSD. But here I am my own self advocate praying for help.

    I hope to have goo news sold
    • Since I was denied several times for a transplant my doctor steered me towards clinical trials.

      There happens to be two I know of in California and I am applying. They are IBV devices put into your lungs through a bronchoscopy method. 

      I am more than anxious to give this a try as I feel like I am on my last leg.  I use oxygen 5 to 6 ltrs. 24/7 and right now have a lung infection that is persistent!

      Has anyone gone through one of these clinical trials for these IBV devices?

      clinicaltrials.gov will take you to one called EMPROVE and the other LIBERATE

      Calm and easy breathing for us all,
      Nan of CA (shadespast)

      • I hope you may get accepted into the trials and that you will find the treatments helpful. Please let us know how it goes for you, and I will be hoping for the best. I will keep you in my thoughts and prayers. Many hugs.

      • Hi Nan

        Welcome back! I admire your determination to take part in a clinical trial. A few years prior to my first transplant, I encouraged a doctor to bring the clinical trial to his hospital and I was in the trial and was happy with the results. I wish you the best!

    • I am glad that you are fighting for answers and hope and not giving up. May your persistence bring about the best for you. I will keep you in my prayers. Many hugs.

    • That is very good news. Keep the wind to your back :)

  • I am sorry to hear this. I wish I had some advice, but I do not have much knowledge in this area. However, I will be sure to keep you in my prayers. I would call your insurance and find out why they denied the transplant, and then start from there to see what can be done. I hope that a way can be found for this situation to end on a better note. May you find the strength you need to keep fighting. Many hugs.

    • Thanks everyone. I called Anthem Blue cross who in turn contacted my pulmonologist and PCP doctor. Since I am an HMO insurance waif I have to have  a referral. A referral was put in but somehow got lost? Also my husband contacted Human Resources where he works and HR has turned my case over to the BC rep for the company. Wheels are in motion and I feel much better. 

      Monday  is a Holiday so I expect to hear something midweek. 

      I am praying UCLA will take me. 

  • There is no doubt in my mind that you will succeed. I would contact the finance dept at the hospital as well as the insurance company and find out the reason and where to go from there.  Maybe you can ask for a case worker? Take names and phone numbers in a special place and perhaps ask the social worker what she/he suggests.

    If anyone out here is listening please share your ideas to help Nan.

  • This sucks.  Try to find an advocacy group for lung transplants.  I'm sure they would know better how to handle this and they probably have some experience with insurance companies.  I agree that having to fight when you are sick is awful but you have to do what you have to do.  Good luck and perhaps others with lung transplants here will respond with more information.

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