I try not to get involved in situations that deal with what is covered and what is not covered via insurance companies. There are just too many variables for all of us to understand. But this is something we can do something about–right now. We need to speak up when we can and today is such a time.
This story came to me via my friends at Beyond Type 1.
I spoke with Faye tonight. Faye’s daughter, Esme, was diagnosed just in February. Turns out Esme’s endocrinologist and her medical team all agree that Esme needs to be on a pump and a CGM. Seems like Faye’s policy in her health insurance company agrees it should be that way too, but the insurance company, Humana, does not.
As Faye stated to me in our conversation tonight, “We wanted to play by the rules and do it right.” Documentation was done. The application was done. The doctors approval was all done. All set, right? Wrong.
Among requests and appeals little Esme and her family have been denied of these life-saving management tools not once, twice, three or even four times, but SIX times. It’s the choice of Esme’s doctors for this management therapy, so who am I to argue? Who is anyone to argue? The most recent decision was made by Humana, according to Faye, “…by an oncologist…” and the “…external hearing may not take place tomorrow because they were informed that they could not find a pediatric endocrinologist.”
Enough; This is sickening.
If I have ever asked you to do something, please send Humana’s CEO Bruce Broussard an email and just ask for a fair hearing to save Esme’s life. Email Mr. Broussard at [email protected] Let him know that the pediatric endocrinologist has spoken, Esme’s medical team has spoken, and all have supplied the necessary paperwork needed, and her case should be heard and decided now.
Tell him to hear the case of Faye Kolly’s daughter Esme and make the correct decision. Why should a two-year-old little girl get caught in this nonsense?
Send the email tonight. Help change a life.
I am a diabetes dad.