Anyone have experience with Anthem BCBS denying LVA surgery? If your insurance approved it, which insurance do you have?

[kbmc]

Recently had my upcoming LVA/LVNA surgery denied by Anthem BCBS and was curious if anyone has had this happen to them with eventual approval. Not sure if I should let the surgical team/office handle the appeals independently, or be more personally involved in the appeals process.

Additionally, if you have had this surgery with insurance approval, which insurance did you have?

Thanks for any feedback and take care of yourselves.

[Lynora]

Hi kbmc - you might need to post this question on a US site - there are a few US members here, but it’s predominantly UK as LSN is based in London.

[Peanutbutter132]

I have Anthem BCBS and just had SAPL surgery on my thigh which they covered at about 80%. Depending on the results of my follow up ICG Lymphography & 5 mo. post op evaluation, I will either go on to have SAPL on my calf followed by LVA/LVNT or straight to LVA/LVNT. I’m not quite there yet, but I’m sorry to hear BCBS is denying coverage for this surgery.

[hshank]

My son, who has lyphedema, was also denied surgery by Anthem Blue Cross. The reason for denial is that the surgery is experimental. I live in California and appealed to the state board which over ruled Anthem and the surgery was allowed. It took a while for the process to go through but it worked. The website for the agency is HealthHelp.ca.gov.

[Gemmie7]

I’m in US and was able to have my insurance pay for my LVA, it took some time and the surgeon handled all the paperwork. After suffering with severe lymphadema for close to 20 years, I definitely benefited from the surgery. When I had Anthem BCBS before I had to keep calling to get approval on other medical treatments, I was even able to get them to purchase a pump. So I’d call and keep calling them it will pay off!!