Living with lung disease and Insurance coverage

Posted by troyhoustonallen @troyhoustonallen, Fri, Aug 2 1:17pm

I have been denied a lung transplant even though I was a good candidate after completing a year and a half of testing and therapy. Now I have done the testing and therapy again and I am awaiting the pre-approval from Wyoming Medicaid. I am wondering if anyone else from Wyoming has had problems with Wyoming Medicaid. My surgery is scheduled for September in Denver Colorado for the zephyr implant surgery for my lungs. I don't know if it's the right name. It is where they go through the throat and into the lungs to put umbrella device in bad parts of the lung to better the good part left. I am in stage 4 COPD and emphysema with 3.7 lung capacity. I have pre-op appointment in September and I have surgery the day after. Has anyone else had this surgery? I will take any info on the insurance and operation that anyone has. TYIA for your time and support. God bless you all have a great day.

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Hi @troyhoustonallen and welcome to Connect. That must be so frustrating struggling with insurance.

I would like to introduce you to fellow Connect members @merpreb @alamogal635 @joangma and @cognac as they all have experience with COPD or other lung disease and may be able to offer you support.

I also would like to share this thread on COPD/Emphysema as you may find it helpful: https://connect.mayoclinic.org/discussion/copd-emphysema/

Back to you @troyhoustonallen how are you feeling? What have your doctor's told you about the surgery?

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@troyhoustonallen– Good morning and welcome to Mayo Connect. I'm so so sorry that after all that you have been through that you are being denied a new lung. Did medicare explain why?

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@merpreb

@troyhoustonallen– Good morning and welcome to Mayo Connect. I'm so so sorry that after all that you have been through that you are being denied a new lung. Did medicare explain why?

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No I tried to have it disputed and because the doctor's and surgeon is from out of state they had no rights to dispute it. We don't have the services I need in Wyoming so that is why they refer you to Montana and Colorado. It was kind of a godsend because I think the zephyr implant is a better option. But I am still waiting for Wy Medicaid to approve the operation.

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After receiving the information that I was denied, (I received the denial info from the lung transplant coordinator in Denver that insurance wouldn't cover the operation) I asked all my doctor's to write appeal letters which they did with no response. What gets me the surgeon said he had done other transplants for other people in Wyoming and he didn't understand why I was denied. Wy. Medicaid has denied a lot of people medications and procedures that would improve people's lives but they deny them the care. I went as far as to write them, the governor, Congress woman Chaney and senators. I received a letter from the Congress woman stating that they could do nothing about it. Aren't they the ones that change law's? Well at any cost I have been praying, exercises, therapy, mentally, physically and spiritually getting myself in alignment with myself and keeping a positive attitude through all. Whatever happens I give it to God and have faith that it is his plan and things will work out. I started a fundraiser for the upcoming surgery and I have back up plans if I have to move to Colorado to get the surgery done. But being on a limited income with very little help I know it will be a battle. I don't want to move from where I am, I have dogs, cat, chickens and my grandma who is going through medical stuff herself to help take care of her she just had her 95th birthday in July. I am grateful for her she is my rock and she is such a blessing. Very strong and independent woman that has been there for me throughout my life. My girlfriend and I are going on 5 years of being together and she has been my main help and support with helping grandma and I in anyway possible. She has part-time business that she started so that she could be there for both of us. She takes me to my appointments and grandma to hers. She is a wonderful person and I am blessed to have her in my life. Thank you for your time and support I do appreciate it. I'm sorry I rambled on but it helps me to get my feelings out and I do it by writing. I am a published author of poetry and I am working on a project called from addiction to God. I am almost finished with it. Still writing and twerking the rough draft but working on the last chapter. Thank you for your support. God bless.

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@troyhoustonallen

After receiving the information that I was denied, (I received the denial info from the lung transplant coordinator in Denver that insurance wouldn't cover the operation) I asked all my doctor's to write appeal letters which they did with no response. What gets me the surgeon said he had done other transplants for other people in Wyoming and he didn't understand why I was denied. Wy. Medicaid has denied a lot of people medications and procedures that would improve people's lives but they deny them the care. I went as far as to write them, the governor, Congress woman Chaney and senators. I received a letter from the Congress woman stating that they could do nothing about it. Aren't they the ones that change law's? Well at any cost I have been praying, exercises, therapy, mentally, physically and spiritually getting myself in alignment with myself and keeping a positive attitude through all. Whatever happens I give it to God and have faith that it is his plan and things will work out. I started a fundraiser for the upcoming surgery and I have back up plans if I have to move to Colorado to get the surgery done. But being on a limited income with very little help I know it will be a battle. I don't want to move from where I am, I have dogs, cat, chickens and my grandma who is going through medical stuff herself to help take care of her she just had her 95th birthday in July. I am grateful for her she is my rock and she is such a blessing. Very strong and independent woman that has been there for me throughout my life. My girlfriend and I are going on 5 years of being together and she has been my main help and support with helping grandma and I in anyway possible. She has part-time business that she started so that she could be there for both of us. She takes me to my appointments and grandma to hers. She is a wonderful person and I am blessed to have her in my life. Thank you for your time and support I do appreciate it. I'm sorry I rambled on but it helps me to get my feelings out and I do it by writing. I am a published author of poetry and I am working on a project called from addiction to God. I am almost finished with it. Still writing and twerking the rough draft but working on the last chapter. Thank you for your support. God bless.

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@troyhoustonallen – I am so so sorry. I'm so speechless when it comes to states that have certain "agendas" denying health care to people. I can't get into it because political discussions are not what Connect is about. I understand why you don't want to move. It's a very huge decision to make abut your health. I would keep trying, call and write everyone you can, keep on everyone until something changes, if not for you than for future generations. My best to you. Will you let us know if anything changes for you?

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@merpreb

@troyhoustonallen – I am so so sorry. I'm so speechless when it comes to states that have certain "agendas" denying health care to people. I can't get into it because political discussions are not what Connect is about. I understand why you don't want to move. It's a very huge decision to make abut your health. I would keep trying, call and write everyone you can, keep on everyone until something changes, if not for you than for future generations. My best to you. Will you let us know if anything changes for you?

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Yes I will thank you so much for your support and encouragement.

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