Blue Sheild denials
I am so lost I really don't know where else to turn. I pay $1,600 a month for gold ppo blue sheild insurance through my husband's job. I do so because I had a sudden onset of crazy fully body sickness happen in 2020. While drs are trying to figure it out, it's alot of testing. I have been diagnosed with multiple things like autoimmune and connective tissue disorders, but the big main cause has not been found. I have 9 specialists and they all need ms protocol imaging done. We tried in 2021 and blue sheild decline and wouldn't budge. Since then I have worsened and almost wheelchair bound most the time. I am loosing so much limb function. Well blue sheild keeps denying any images of brain, brainstem, cervical and all of my back. In 4 years on ppo they won't approve any. No one can see anything because of this and I'm worsening. This new round of mris were trying for is MS protocol. Yet blue sheild has denied saying it's not "medically necessary ". They have all my health records and it should be obvious to anyone with eyes that these images are so dire now. Instead they denied saying I need to do physically therapy and exercise at home. Which in the last 4 years has happened quiet a bit, it didn't improve. Now, it's impossible for me to do the exercises they are wanting through physical therapy because my legs don't work. My drs are going to bat for me so hard. We can't give them something that's impossible. But also , when it's ms protocol no exercise anything should be part of the equation. My doctors are floored and none of us know what to. While they are doing this, I get worse and worse. My biggest fear is perment progression as I'm only 33. Any advice would be greatly appricated. We have done everything they asked, peer to peers, trying to overturn denials. We get them everything they ask for to appeal and they still deny , then we restart the process.
submitted by /u/Internal_Ride_258
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