hi folks,

i had radiation and chemo in '01, so i don't produce much saliva anymore. i've been on prescription fluoride toothpaste since then. always approved by BCBS, until this past week...

denied, denied, denied. sounds like Suze Orman has gone to work at BCBS.... they claim that it is excluded because it is 'preventative' dental.

i need to send letter to them, which will be reviewed by outsiders, to overrule their assertion.

i'm seeking some help putting this together... i suppose that other folks are likely run into this, so i suspect that a 'form' letter on this site would be helpful.

i'm thinking that this should be payable because
(a) i have a medical condition that requires it. this is an existing condition (what's it called)?
(b) the medication is treatment for the condition.. 'treatment' not prevention!!
(c) flouride is a minineral
(b) the toothpaste is only available by prescription

given those factors, my claim doesn't fit their exclusion,
it fits under normal prescription terms.

am i close?

cu,
larryb

'01 diagnosis.. jaw hing and base of tongue. surgery not possible. JHU used radiation and chemo to seemingly rid me of the beast. peg for about 19 months. 100 cases of 24 cans of liquid food. 9 months eating therapy. 3x esophagus stretches. non-smoker. previously a social drinker.