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Insurance has denied coverage for growth hormone

Discussion in 'Parents Off Topic' started by Jaredsmom, Aug 8, 2012.

  1. Jaredsmom

    Jaredsmom Approved members

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    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.:mad:
     
  2. valerie k

    valerie k Approved members

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    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.
     
  3. heamwdevine

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    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.
     
  4. Jaredsmom

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    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.
     
  5. sooz

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    That is so frustrating! The 1/4 inch growth is really promising too. I hope the appeals work!
     
  6. Traci

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    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!
     
  7. Lisa P.

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    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. valerie k

    valerie k Approved members

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    get back to the office and get more samples.... they should be more then happy to give them to you given the circumstances.:cwds:
     
  9. Jaredsmom

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    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.
     
  10. Lakeman

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    Good luck with your appeal. In the mean time perhaps reading articles like this one might offer something to do:

    http://www.lef.org/magazine/mag2009...009_Enhancing-Growth-Hormone-Naturally_01.htm
     

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