Public Safety Brother in Need
Donation protected
Need - Our friend, John Carter, is a 27-year public safety veteran and 20-year employee of York County, SC Public Safety Communications and needs your help. His life and career have been one of service to others, from working accident scenes as head of a rescue squad to being part of the dive team for York County, and now head of Technical Services of Public Safety Communications (his true calling for anyone that knows him).
Why? – John needs a complete hip replacement, but without significant weight loss the doctors cannot perform the hip replacement. He now struggles to walk, exercise, or perform normal daily routines, not because of his weight but because of his hip. He has been in a yearlong fight with Blue Cross & Blue Shield of South Carolina, their appeals board, and then the Public Employee Benefits Authority (PEBA), to cover a medically necessary gastric sleeve surgery needed to get to the ultimate goal of a hip replacement (which Blue Cross WILL cover). Although his primary doctor, his orthopedic doctor, and his hepatologist all deem the gastric sleeve medically necessary, PEBA continues to deny coverage. Based on the statement of the last appeals board from SC PEBA, “after review of your file along with relevant provisions, PEBA found your request….DENIED... because the Plan specifically states weight loss surgery is excluded.” Essentially, PEBA has overruled the medical advice of three well-respected, highly educated, and experienced physicians that deem this surgery medically necessary.
Irony – Anyone who knows John knows he absolutely loves his career in Public Safety. He wants to continue serving his community and York County, ensuring our first responders can safely communicate and go home to their loved ones. But without this surgery and ultimately a hip replacement, his career will be limited. Blue Cross & Blue Shield of South Carolina/PEBA will pay for other medical conditions associated with his current situation that far exceeds the cost of this surgery but will not pay for the gastric sleeve. John could file for disability retirement, go on Medicare, and receive the surgery through the Medicare program, but John still has too much life to give to sit at home on disability.
If John had made a different career choice and chosen to use his skills and expertise to serve a community 20 miles up the road in NC, John’s surgery would be covered through North Carolina’s Public Employee Insurance as they cover the medical expense for their employees.
Daily Life in Pain - We know that many people will look at John’s situation and think he just needs to exercise or eat the right foods and diet. Keta (his wife), who is with him most often, knows what he eats, and they are eating healthy foods that are low in carbohydrates and he is watching his quantity of food intake. Others may say that he needs to exercise, and she can attest to him trying to exercise and being in such severe pain afterward that he is taking pain meds and being unable to walk. He tried swimming at the pool using just his arms and he partially tore the rotator cuff in his right shoulder. While trying these things, he has not lost any significant weight.
Surgery Needed - John can no longer walk without severe pain. He cannot put his socks and shoes on without assistance. He technically could easily apply for disability, but he loves his career and serving his community and knows he has many years of service left. With all of this in mind, he needs weight loss surgery, which is not necessarily the easy way because it requires major life changes that are irreversible. Without this surgery, he will need to seek disability.
Options for Self-Pay –
· Atrium (formerly Carolinas Healthcare) in Charlotte, NC charges in a range from $29,000 to $51,000.
· Roper St. Francis in Charleston charges $14,000 with additional coverage for any complications after the surgery of $2,569.87. (This is the chosen option after meeting with the surgeon in Charleston.)
Donate to Help – Please help keep John, the dedicated South Carolina Public Safety Communication employee, on the job. Help him and enable him to keep helping others for many years to come.
John is a very loving, helpful and generous man and has chosen a career that helps others. And he is very determined to keep working and helping ensure the safety of others.
This is now his chance to receive help from others that can change his life for the better, to receive the chance for surgery that will allow him to positively impact others through his continued service to York County and the citizens of South and North Carolina. Your donation will provide a positive impact and will improve his life.
Thank You – Thank you to all friends, family, and Public Safety brothers and sisters choose to donate to help a friend in need.
Why? – John needs a complete hip replacement, but without significant weight loss the doctors cannot perform the hip replacement. He now struggles to walk, exercise, or perform normal daily routines, not because of his weight but because of his hip. He has been in a yearlong fight with Blue Cross & Blue Shield of South Carolina, their appeals board, and then the Public Employee Benefits Authority (PEBA), to cover a medically necessary gastric sleeve surgery needed to get to the ultimate goal of a hip replacement (which Blue Cross WILL cover). Although his primary doctor, his orthopedic doctor, and his hepatologist all deem the gastric sleeve medically necessary, PEBA continues to deny coverage. Based on the statement of the last appeals board from SC PEBA, “after review of your file along with relevant provisions, PEBA found your request….DENIED... because the Plan specifically states weight loss surgery is excluded.” Essentially, PEBA has overruled the medical advice of three well-respected, highly educated, and experienced physicians that deem this surgery medically necessary.
Irony – Anyone who knows John knows he absolutely loves his career in Public Safety. He wants to continue serving his community and York County, ensuring our first responders can safely communicate and go home to their loved ones. But without this surgery and ultimately a hip replacement, his career will be limited. Blue Cross & Blue Shield of South Carolina/PEBA will pay for other medical conditions associated with his current situation that far exceeds the cost of this surgery but will not pay for the gastric sleeve. John could file for disability retirement, go on Medicare, and receive the surgery through the Medicare program, but John still has too much life to give to sit at home on disability.
If John had made a different career choice and chosen to use his skills and expertise to serve a community 20 miles up the road in NC, John’s surgery would be covered through North Carolina’s Public Employee Insurance as they cover the medical expense for their employees.
Daily Life in Pain - We know that many people will look at John’s situation and think he just needs to exercise or eat the right foods and diet. Keta (his wife), who is with him most often, knows what he eats, and they are eating healthy foods that are low in carbohydrates and he is watching his quantity of food intake. Others may say that he needs to exercise, and she can attest to him trying to exercise and being in such severe pain afterward that he is taking pain meds and being unable to walk. He tried swimming at the pool using just his arms and he partially tore the rotator cuff in his right shoulder. While trying these things, he has not lost any significant weight.
Surgery Needed - John can no longer walk without severe pain. He cannot put his socks and shoes on without assistance. He technically could easily apply for disability, but he loves his career and serving his community and knows he has many years of service left. With all of this in mind, he needs weight loss surgery, which is not necessarily the easy way because it requires major life changes that are irreversible. Without this surgery, he will need to seek disability.
Options for Self-Pay –
· Atrium (formerly Carolinas Healthcare) in Charlotte, NC charges in a range from $29,000 to $51,000.
· Roper St. Francis in Charleston charges $14,000 with additional coverage for any complications after the surgery of $2,569.87. (This is the chosen option after meeting with the surgeon in Charleston.)
Donate to Help – Please help keep John, the dedicated South Carolina Public Safety Communication employee, on the job. Help him and enable him to keep helping others for many years to come.
John is a very loving, helpful and generous man and has chosen a career that helps others. And he is very determined to keep working and helping ensure the safety of others.
This is now his chance to receive help from others that can change his life for the better, to receive the chance for surgery that will allow him to positively impact others through his continued service to York County and the citizens of South and North Carolina. Your donation will provide a positive impact and will improve his life.
Thank You – Thank you to all friends, family, and Public Safety brothers and sisters choose to donate to help a friend in need.
Fundraising team: Friends of John Carter (4)
Gary Loflin
Organizer
Rock Hill, SC
John Carter
Beneficiary
John Carter
Team member
Kevin Wilhide
Team member
Keta Carter
Team member
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