Mother denied formula her baby needs to survive

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Lovejac

Lovejac

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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
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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.
 
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.
 
I hope she had her doctor write a letter to the insurance company.
 
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.
 
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!.....
 
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.
 
wildTrose said:
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!
Click to expand...
wildTrose said:
and all they needed to live was treatment!.....
Click to expand...



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.zhtml?c=70296&p=irol-govBoard
 
lew657 said:



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.zhtml?c=70296&p=irol-govBoard
Click to expand...

Thanks lew657 - I will do this.
 
wildTrose said:
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!.....
Click to expand...

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.
 
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...
 
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.)
 
lew657 said:



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.zhtml?c=70296&p=irol-govBoard
Click to expand...
Thank you for the information. I just sent an email off to them.
 
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 :eek:
 
Boyz_Mum said:
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.)
Click to expand...

Here's what I wrote:

Dear Ms. McCabe,

I am writing to you as the Investor Relations contact for HealthNet, a publicly traded company. I am appalled at the story that I read today regarding HealthNet's denial of coverage for formula that an infant child needs to survive and thrive. (http://www.msnbc.msn.com/id/30200203/) I am an active investor in the stock market and would never consider investing in this company. I would suggest that you review this terrible decision unless you want to see your stock plummet to even lower values. Please do the right thing for this child.

Kindly,

Southcitymom
Atlanta, Georgia
 
Ugh this is the type of thing that pisses me off to no end.

This happens everyday with these companies. Denying people what they need to survive because of f'in greed! It sickening.
 
Thank you very much SCM.

I am not hoping to sound like a dolt, but sometimes my own words fail me.

Ms. Heather, I agree with you. In a small sector of society, this type of situation leads to the break up of family "units". It's a very terrible side of a "profit margin".

:blowkiss:
 
Great idea! I have emailed the company as well.
 
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