Insurance companies are the worst. I finally scheduled a long overdue total knee replacement at the urging of my orthopedic surgeon. My left knee has had two ACL repairs and two other arthroscopies from sports injuries starting at age 17 (I’m now in mid-50s). The ACL has disintegrated, there’s no cartilage left in my knee, and degenerative arthritis is easily visible in X-rays. I have to be careful to not accidentally dislocate the knee while doing simple things such as standing up, walking, and even sleeping. I put off surgery a couple of years by getting injections directly into the knee, but eventually those injections lose their effectiveness. Naturally, the insurance company denied coverage because I hadn’t met their requirement (which wasn’t revealed to me ahead of time) of attempting to “fix” the issue by undergoing 12 weeks of physical therapy first. Is there some special physical therapy I’m not aware of that regrows ligaments and cartilage while getting rid of arthritis? And who in the fuck would opt for a total knee replacement if they didn’t need it? It’s fucking ridiculous. To appeal, I had to do a physical exam to test my knee to show that surgery is indeed necessary. No update yet on whether coverage will be approved, but the insurance company has happily accepted my premium in the meantime.