Rachel's stage 2 appeal denied

[3kids4me]

I just got the news and I am in total shock. I am so angry and so upset. I can't believe they are doing this to my little girl.

The next stage is to appeal through the state insurance board. I don't know how much strength I have left and I simply cannot believe that any sane person would not give a treatment a chance (even a three month trial) when everything else has failed.

Just wanted to let you all know. Thanks for your prayers and support.

 

[GotAnyPins]

Isn't he the one that is always is going about insurance for everybody...I think he meant they
actually had to pay too...Have you contacted any of the newspapers w/ your story..one couple down had the same problem w/ their child, and after publicizing it in the papers, all of a sudden, the insurance company found out that they could help her...they must have gotten a ton of bad press...I doesn't hurt..

I sure will pray that something will work..as you said it is unbelievable, and they all must be insane..it is like our kids are second class citizens.

 

[LynniethePooh]

Sharon
Prayers and thoughts are with you and your family as always. I like what Donna suggests. I know your mental and physical reserves are at an all time low right now, and you would prefer not to make this a public display, but I think the last straw has been placed.
However you decide to proceed, know you have our full support and prayers always.
Hugs

 

[BeautyLLM]

Sharon, I am so sorry your appeal was denied. You are right, it makes no logical sense at all...but as we all know, the insurance companies are in business to make money, not to provide healthcare. What a horrible state of affairs our country is in.

I agree with Donna...maybe the squeaky wheel does indeed get the grease...I would write letters to the editor of the local CT papers and maybe even talk to consumer reporters from some of the local tv stations...it couldn't hurt..

 

[lovingthemouse]

Ok Sharon - you are not giving up, and we know, although you are tired, that fighting for your children is your primary concern. Channel 3 - Hartford - has their Eye team and Channel 30 - New Britain- their "in depth" reporter. Make a call- make a few calls. The right person is waiting to hear from you.
Rachel and the family will continue to stay in our prayers. Caroline

 

[jojo_ct]

Sharon,

A huge hug for you and for Rachel...

It's so sad I have no words.

Cynthia

 

[mousefan]

This type of insurance crap makes me so angry. I haven't been around much to post but have been trying to follow this story. I agree, the squeaky wheel does get the grease, and contacting the local media might just get the ball running, in fact IF the local media gets several letters from all over the country ( meaning from our own DIS family here) it just might help. Maybe if someone can get us who live out of the area some info on who to write via snail mail, email, fax or how ever we can contact them with some info we just might get some notice for this poor child to get the treatment she needs.
Don't give up.....our children have to come first...and I am so tired of hearing that these insurance companies refuse to permit treatment for anyone especially a child who so needs it.

 

[Luv2Roam]

I am so sorry to hear this. I can't imagine how difficult this must be for your family.
{{{ }}}

 

[Buzz2001]

Hi Sharon,

Those darn insurance companies hate to give up money. They have no problem taking it but when it comes to giving it back to those in need, they want you to jump through hoops. Don't give up because that is exactly what they want you to do. Then they win. Our thoughts and prayers are with you. Be strong!

 

[SueEllen]

I agree--contact your local media, both Newspaper and TV. It can't hurt and may help your case a LOT. No business likes bad press.

Your family is in my prayers--sending some more pixie dust your way.

Sue Ellen

 

[Mickey527]

Sharon,
You know I am horrified to hear this news. Yesterday when we chatted I really felt that you were feeling good about the news to come.
Defintely go to the newspeople. I remember reading about that family in Wilton who were all diagnosed with Lyme who had no coverage until they had the media on their side.
We are all behind you and if you ever need anything you know my phone number, I will always make time for you and the kids.
For now, think of your upcoming trip to DL and focus on that. Notify the media and let them do what they can, you rest for a while. Peggie

 

[JudithM]

Sharon, I was just thinking about you all earlier today. I am so sorry to read your appeal was denied. My thoughts & prayers are with you all. No one will fight as hard for a child as the parents - you will find the strength to continue this fight. I like the previous suggestions about contacting the media.

 

[fklhou]

I do not frequent this board but your thread grabbed my attention. I had a similar problem with my insurance on a sleep study for apnea. I appealed to the state insurance board (in Texas the form is available online) and while it took some time, I got a favorable result. While I could had sued, it would had been uncomfortable for me with my lawpartners and could had affected the renewal of our health insurance.
Contact your local bar association and see if you can get some pro bono help. Several years ago, we saw an article about a person having a problem with an insurance company that we used to use about a transplant. We had previously had a fight with that insurance company and got some claims covered by confronting the with the language in the contract and providing some case law on our side. We contacted the attorney and provided them with an affidavit on our dispute and the contract intrepretation the company tooked in our case (which was opposite of the position that the insurance company took with us). The case was being handled on a pro bono basis by a good firm and they got a federal judge to order the insurance company to file the papers necessary to put the person back on the transplant list.
Good luck.

 

[tigger2esq]

this is terrible to hear--please keep your chin up and know that we are all praying for you and Rachel!

 

[suzanneb]

Sharon. I know you're exhausted by all this. Yes, I cannot understand why they couldn't let your child try this regimen for a few months...it's unconscionable on the insurance agency's part..booo boo on them. Shame on them...

 

[NHMickey]

We are all pulling for you Sharon. We know it will all work out. Keep Positive!!!

 

[Eeyore's Pal]

Sharon,

I agree with all the above. There should be nothing more important that Rachel's welfare. Get her story in the public eye and watch those rats run for cover. <i>This is the part where I smack insurance reps around and land in jail.</i>

How far are you from a Shriner's hospital? Have you contacted them about Rachel? I believe that they take whatever insurance will pay and if that's nothing, then they still will treat the child.

And there are other childrens hospitals that work this way too. The Childrens National Medical Center here in Washington operates with this policy too.

Have you asked your pediatric neurologist if he has investigated applicable current studies at NIH? Perhaps he can find a study to which Rachel may be referred. If so, all her medical care will be covered by NIH.

Have you considered Voodoo? <i>Just trying to cover all bases.</i>

 

[atlnewf]

I can't say anything that hasn't already been said. There are local news teams that investigate and help out people that really need it locally. I would think your local area has some as well. Definitely contact the media about it. I'd seriously consider some of the other children's hospitals around the country as well. I know many will take whatever they can get from insurance and the rest is raised through public support. I'd check out the children's miracle network for assistance, maybe? http://www.cmn.org/

 

[Raulandpinboy]

I wish there something I or Donna could do to help, if there is anything you need or that we could do to help let us know.

Prayers and best wishes from the two of us.

 

[GotAnyPins]

But another hospital that is supposed to help all is St Judes..and as Ashley and Robyn, and I suggested, get it in the public eye, most of your local tv news have a team that covers this kind of stuff...and they carry a lot of clout..