|
|
#1
08-08-2012, 01:17 PM
|
|||
|
|||
Insurance has denied coverage for growth hormone
Our insurance has flat out denied to pay for Jared's growth hormone tx and so unless we win the lottery we can't afford to pay for it either. I am so pissed off that they let him go though all that testing and strung us along all summer and they are just now telling us our policy does not cover growth hormone. You know how sometimes you get so pissed off you start to cry well that's where I'm at now.
__________________
Stacy mom to: Jared DOB 6/17/99 type1 dx 12/04 dx Growth hormone deficient 5/12 Omnipod 4/08-12/12 Dexcom G7 3/12 DexcomG4 12/12 Animas ping with contact detach and Novalog 12/12 Alex DOB 3/19/97 non D , ADHD and Aspergers 
|
|
#2
08-08-2012, 02:54 PM
|
||||
|
||||
I would appeal and appeal to higher ups.
I would also contact the dr, and see what they can do for you, I would also try and contacting the company that makes the drug and see if they have programs to help those who dont get insurance coverage and cant afford the drugs. hang in there and become the squeeky wheel, sometimes, thats what is takes, is becoming a pain in someones butt.
__________________
mom to kenny 18 erika 14 matt 13 dx'd 1-14-07 pumping minimed 723, 2-29-08 fur mom to cats skeeter 15 RIP angel boy, jack 7, kitkat 5 holly-dolly 3 gizmo 10 and weasel 3 Dogs-penelope-7 also type 1 diabetic on humalog Yoda 1, who should have been named chewy!. avatar-chilliebean chillin on his house
|
|
#3
08-08-2012, 03:09 PM
|
||||
|
||||
|
Yes, if it's something your docter prescribed for him, they just need to call the insurance company and say that it's medically necessary and then it should hopefully be ok.
__________________
Heather-mom to: Anna(11) 2/16/02 dx T1 2/5/09 Pumping with the MM Paradigm Insulin Pump since 7/2009 and occassionaly CGMS, Levemir, trying the Omnipod! Matthew(9) 2/25/04(non-D) Weston(6) 3/14/07(non-D)
|
|
#4
08-08-2012, 03:31 PM
|
|||
|
|||
|
We have decided to appeal. His CDE who is handling this is currently on vacation so we will be contacting her and letting her know of our decision to appeal. Jared was determined though lots of testing to have a moderate deficiency. The endos office gave him samples of norditropin which lasted about 2 weeks and he will run out of those tomorrow. We have been battling to get his bgs back in range and now we wil be back at square one. On the plus side over the past 2 weeks he grew a little over 1/4". So it was definitely working.
__________________
Stacy mom to: Jared DOB 6/17/99 type1 dx 12/04 dx Growth hormone deficient 5/12 Omnipod 4/08-12/12 Dexcom G7 3/12 DexcomG4 12/12 Animas ping with contact detach and Novalog 12/12 Alex DOB 3/19/97 non D , ADHD and Aspergers
|
|
#5
08-08-2012, 03:51 PM
|
|||
|
|||
|
That is so frustrating! The 1/4 inch growth is really promising too. I hope the appeals work!
__________________
Susan Grandma to Hailey age 10 dx type 1 age 4 pumping with Omnipod since 8/09 and Faith age 7 and now little Macey Ella age 1 year Dx with allergies to nuts, wheat, eggs, and soy True heroism consists in being superior to the ills of life, in whatever shape they may challenge us to combat. Napoleon I (1769-1821) Napoleon Bonaparte. French general.
|
|
#6
08-08-2012, 05:55 PM
|
|||
|
|||
|
Appeal, appeal, appeal. Let me tell you, they killed a whole forest of trees with their denial letters when I had premature triplets in the NICU...they denied routine things for all kinds of crazy reasons. I learned to appeal...early and often.
 . With d stuff, I'm always spoiling for a fight with them, but so far, they have been "reasonable" about most things. Good luck to you!
__________________
Traci Mom to dsd23, ds13, dd13, dd13, and ds12-dx'd at 23 months Pumping with a cool blue Cozmo from 4/07 until 7/09 and now on Omnipod.
|
|
#7
08-08-2012, 06:57 PM
|
||||
|
||||
|
I echo the others.
No doesn't always mean no with insurance. In fact, sometimes they didn't even "want" to say no, something just got auto-rejected. Try to talk to a person (you'll have to move up a few tiers, the first guy who answers won't know anything) and ask specifically why it was rejected -- is this drug always not paid for? Was there something about his particular diagnosis? Is there another drug that is a viable alternative that they do cover? Find out exactly what you need to do to get them to pay for it. If you are insured through work, talk to the HR department, they may be able to help you navigate with insurance since they've worked with them.
|
|
#8
08-09-2012, 01:00 PM
|
||||
|
||||
|
get back to the office and get more samples.... they should be more then happy to give them to you given the circumstances.
__________________
mom to kenny 18 erika 14 matt 13 dx'd 1-14-07 pumping minimed 723, 2-29-08 fur mom to cats skeeter 15 RIP angel boy, jack 7, kitkat 5 holly-dolly 3 gizmo 10 and weasel 3 Dogs-penelope-7 also type 1 diabetic on humalog Yoda 1, who should have been named chewy!. avatar-chilliebean chillin on his house
|
|
#9
08-09-2012, 03:13 PM
|
|||
|
|||
|
They unfortunately don't have any more samples they gave us all they had to get him started which will be gone on Friday. Unfortunaly since this has impacted his insulin needs so much we don't know exactly how to handle his basels and ratios once he goes off of it weather we need to return to former basals 24 hrs after his last dose is given or what. Getting a little peeved at his endos office at this point as they said they would call me and tell me how to handle it. I have called 3 times keep getting the speech a nurse will call you.
__________________
Stacy mom to: Jared DOB 6/17/99 type1 dx 12/04 dx Growth hormone deficient 5/12 Omnipod 4/08-12/12 Dexcom G7 3/12 DexcomG4 12/12 Animas ping with contact detach and Novalog 12/12 Alex DOB 3/19/97 non D , ADHD and Aspergers
|
|
#10
08-09-2012, 06:44 PM
|
|||
|
|||
|
Quote:
http://www.lef.org/magazine/mag2009/...turally_01.htm
__________________
Alan father of daughter with T1D born 2/2005 Diagnosed 9/07/10, MDI, non D Son born 11/00.
|
 |
| Bookmarks |
| Thread Tools | |
|
|
