October 26, 2009


I received a letter from my insurance company today confirming that my doctor had requested coverage for my PRP injection, what they referred to as "Removal of tissue for graft, Autologous blood process." The decision? The medical director reviewed the request and determined it was "Denied - Not Medically Necessary." The letter went on to explain that tissue grafts are not approved for my specific condition and there is insufficient medical evidence to support the procedure.

I hope they enjoy paying for the months and months of physical therapy, follow up MRIs, regular appointments with my podiatrist and likely someday the surgery or other treatment that will be needed to correct my chronic condition and resulting scar tissue. Medical insurance companies absolutely infuriate me with their short-sightedness.

So my recovery will continue as massive waiting game. I realized today it's been two months since it all began. Just two months out of the four to six I need to be recovered. I've lost so much in that two months that will take me an additional two months to regain. But on the bright side, I am getting better and now that PRP is out for sure, I'll likely start PT and hope for the best. Hope and waiting seem to be the only things my costly monthly premium covers.


  1. Sorry about the bad news! I guess the positive is that a decision has been made and you don't have to hang in limbo anymore.

    I'm sure that once you get through the PT and healing process you will bounce back quicker than you think. Besides, winter is just about upon us and it gives you an excuse to avoid running in the snow :)

  2. Kristin...you can always appeal the decision..insurance companies deny just about everything. Just a thought. You have a right as a patient to elevate the process.

  3. I agree with Stacey's suggestion - appeal the decision while you move on with a more traditional rehab plan. Can't hurt, right?

  4. What Stacey said ^^ hang in there, girlie ((()))

  5. Bummer!!! Is all I can say. Keep your chin up!an



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