Question:
What are my chances of getting approved by SC medicaid w/o letter

of medical necessity from PCP? should i just give up for now, i can't fantom the thought of giving up but I feel it is hopeless?    — deniece M. (posted on November 8, 2002)

November 7, 2002
First of all, let me say that it is NOT hopeless! I am not totally up to date on what SC Medicaid will pay for and what they require, but I have GA Medicaid, and I didn't have to have a referral at all. My PCP was very supportive, and willing to write me the letter, but it was not required. You say in your profile that your appointment with the surgeon went great, and I am wondering if you have already seen him why you need a PCP referral now? Is it that Medicaid is requiring you to have your PCP's approval? If so, I would just change PCP's. That should be pretty simple, call around and find out who will take your insurance, and tell them upfront what you are looking for and they will be able to help you. Maybe you can even call the surgeon office and ask them who they recommend you change to. I am sure that they know which local PCP's will be supportive. Please so not feel hopeless, you will work it all out! Please email me if you would like to talk more, I am having surgery on December 9th, and have finished all test and required appointment except for preops. I am also a full time nursing student, I would love to talk to you! Healthier and Happier days to come!
   — poohdotsmom2