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  1. #1
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    Mother denied formula her baby needs to survive

    http://www.msnbc.msn.com/id/30200203/

    ''It was devastating. He was just so frail. He wasn’t growing, losing weight. The blood draws, everything; it just makes me really sad,'' Mosier explained. Mosier says her son went from Mercy Hospital to Memorial, and even the Children's Hospital in Madera before doctors discovered he suffers from an inborn error of metabolism.

    Dr. Anthony Thomas says Brauthner's body can't break down protein so he needs an amino-acid based formula like Elecare. But Mosier says Health Net Insurance denied her coverage for the formula twice. She says the insurance company told her Brauthner's condition is not life-threatening and it is not considered a medical food because the formula is not fed through a feeding tube
    Say what you mean, mean what you say, but don't say it mean.
    We are all just trying to make sense of an unimaginable crime.

  2. #2
    Ezryder9's Avatar
    Ezryder9 is offline Yes it's a Harley and no, you can't ride it!
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    This is a heart wrenching story. I'm gonna pray for this little guy really really hard. Hopefully the insurance company will reconsider and give the family the help they obviously need. Yet, in California, the taxpayers are being asked to pay $2,000 a month for Octo-mom's babies? Don't get me wrong. I don't begrudge those babies anything. Only their mother. Perhaps this mom could get some help from some local or state program.
    Unless substantiated with a link, all comments are nothing more than my personal opinion. And opinions are like, well, noses; we all have one.

  3. #3
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    So sad, but not surprising.

    My friend who had a baby born at 25 weeks had to feed him Pediasure through a tube for almost a year when he got out of the hospital (and even for a long time after the tube was out). It was about $300/case back then, about 15 years ago, but was not covered at all b/c it wasn't "medicine" or a prescription or whatever. I remember it being a serious strain.

    I'm not sure what these families are supposed to do, but it seems like they should get some help when they have a medical condition that requires it.

  4. #4
    SewingDeb's Avatar
    SewingDeb is offline "Sorry, I'm not qualified to land the plane."
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    I hope she had her doctor write a letter to the insurance company.

  5. #5
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    I hope the negative publicity for the insurance company will cause them to re-consider. I've really grown to hate insurance companies. I know they have to protect themself from fraud but it's gotten ridiculous. You pay huge premiums and for what? So they can deny you treatment, prescriptions, etc.

    It would be nice if the manufacturer could donate some formula to this mother and her baby. It would be good publicity, they'd get a tax write off for a donation and the baby would have the food that he needs.

  6. #6
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    the insurance company will not change it mind! there are thousands of people every day that die because the insurance companies will not pay for their treatment!
    and all they needed to live was treatment!.....

  7. #7
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    This type of situation is heartwrenching. I am praying that there is a Crippled Children's type organization that will come through for this family or a generous corporate sponsor.

  8. #8
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    Quote Originally Posted by wildTrose View Post
    the insurance company will not change it mind! there are thousands of people every day that die because the insurance companies will not pay for their treatment!
    Quote Originally Posted by wildTrose View Post
    and all they needed to live was treatment!.....



    I have personally seen insurance companies change their policy on what they will cover in a situation. It does take work - let's be honest they are a for profit business and make their decisions based on the bottomline. The bottom line here is taht Health Net is a publicly traded insurance company.... meaning public opinion matters to them since it can impact share prices. So here is some contact information and a link to the Board of Directors and Senior Management... If anyone has the time to spare for this child - write a letter or call - let them know that we the public who can buy ownership in their company want to see them "do the right thing" for this child.

    Angie McCabe
    VP, Investor Relations
    Health Net, Inc.
    21650 Oxnard Street
    Woodland Hills, CA 91367
    E-mail: Investor.Relations@healthnet.com


    http://investor.health.net/phoenix.z...=irol-govBoard

  9. #9
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    Quote Originally Posted by lew657 View Post


    I have personally seen insurance companies change their policy on what they will cover in a situation. It does take work - let's be honest they are a for profit business and make their decisions based on the bottomline. The bottom line here is taht Health Net is a publicly traded insurance company.... meaning public opinion matters to them since it can impact share prices. So here is some contact information and a link to the Board of Directors and Senior Management... If anyone has the time to spare for this child - write a letter or call - let them know that we the public who can buy ownership in their company want to see them "do the right thing" for this child.

    Angie McCabe
    VP, Investor Relations
    Health Net, Inc.
    21650 Oxnard Street
    Woodland Hills, CA 91367
    E-mail: Investor.Relations@healthnet.com


    http://investor.health.net/phoenix.z...=irol-govBoard
    Thanks lew657 - I will do this.
    I do not intend to tiptoe through life only to arrive safely at death!

  10. #10
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    Quote Originally Posted by wildTrose View Post
    the insurance company will not change it mind! there are thousands of people every day that die because the insurance companies will not pay for their treatment!
    and all they needed to live was treatment!.....
    I'm going to take Lew's advice and advocate for this child, but, in my heart, what you say rings true to me. I loathe insurance companies for so many reasons - even though I have great health insurance that has never denied a thing, I don't trust the industry as a whole.
    I do not intend to tiptoe through life only to arrive safely at death!


  11. #11
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    Thank you lew657. I have sent them a letter!

  12. #12
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    Jul 2008
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    Ditto...and I've forwarded on a request for everyone in my address book to do the same...hope we can somehow get an update on this story...

  13. #13
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    Mar 2005
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    Will someone offer a "format" of the letter they've sent to the company? I don't know what to include for a letter like this. (Thanks in advance if someone can help.)

  14. #14
    Join Date
    Nov 2003
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    Florida
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    Quote Originally Posted by lew657 View Post


    I have personally seen insurance companies change their policy on what they will cover in a situation. It does take work - let's be honest they are a for profit business and make their decisions based on the bottomline. The bottom line here is taht Health Net is a publicly traded insurance company.... meaning public opinion matters to them since it can impact share prices. So here is some contact information and a link to the Board of Directors and Senior Management... If anyone has the time to spare for this child - write a letter or call - let them know that we the public who can buy ownership in their company want to see them "do the right thing" for this child.

    Angie McCabe
    VP, Investor Relations
    Health Net, Inc.
    21650 Oxnard Street
    Woodland Hills, CA 91367
    E-mail: Investor.Relations@healthnet.com


    http://investor.health.net/phoenix.z...=irol-govBoard
    Thank you for the information. I just sent an email off to them.
    Prayers for all murdered wives and children. My posts are my opinion only.

  15. #15
    Join Date
    Nov 2006
    Posts
    224
    If anyone knows how to contact the reporter or mom, Abbott has a patient assistance program which can be linked to through the Elecare web page. http://elecare.com/obtain.aspx The direct link to Partnership for Prescription Assistance https://www.pparx.org/Intro.php 1-888-477-2669. Yikes, fwiw, six 14 ounce cans cost $189.00. When mine was a little guy he would easily polish off 6-8 4 oz. bottles a day, this would have cost over $440.00 a week

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