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My appeal letter was about me. Why I think I should be approved. I stated that my diabetes was getting out of control and the next step was a pump (backed up with a letter from by PCP. I am 61 and in the process of raising my 2 grandsons (4 & 6) and would like to be healthy to enjoy them growing up and have the energy needed to keep up with them.

My though is that BCBS just read 43775 and denied. The appeal board reads what is submitted and looks at you case by case. I did have some references but I don't think that helped much.

I also searched the sites for some examples - but wound up just being myself and stating my case.

It is important that you meet the requirements stated in their policy and just need the extra push because VSG is still "investigational"

Lou

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