[Kelly4ADR]

Oh how I hate to even have to say it, but my third and final external appeal was denied this week.

I saw my surgeon on Wednesday who was so mad at Aetna on my behalf that he called his CEO over from another building and we had a meeting about what direction they are taking next with my case. Apparently he had a patient with the same surgery get approved by Aetna last week.

I asked that they submit in the mean time a request for authorization where Aetna pays for 1 level and I will pay for the other. Done this way it will only cost me about 16k out of pocket. They can deny this option as well, leaving me right back in the appeals process...and I am admittedly getting weary.

I want to remain thankful for the insurance coverage I do have, even in light of this. Some are without, some pay through the nose for insurance that covers nothing, and I know I do have a great plan all in all. Glass half full is where I like my mind to stay. BUT...I sure would like to have surgery now. My hopes are that Aetna will agree with the new plan and I can get my cervical spine stable, as I still have lumbar issues to contend with. After that, if my surgeon and his CEO want to make something of my case and go some rounds with Aetna, have at. It is, and has been the principle of the matter with Aetna, but at some point I need to get fixed!