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doing the happy dance, figured I'd share

Forum: Children with Special Needs


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September 25th, 2009, 01:17 PM
Daisyfields's Avatar Platinum Super Mega Mommy
Join Date: Apr 2007
Location: In the enchanted forest
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I've been fighting w/ the insurance companies about my DS Alimentum formula, since June they've been DENYING his Rx to eat, saying I wasn't doing enough & that it wasn't a necessity.

This past time of doing the prior-authorization & appealing, I included the specialists letters that I had them send me, and then, I wrote a personal letter to the insurance company, letting them know about Teighan's allergies & skin disorders. I was about to drive to the insurance company's headquarters (an hour away) & sit there on their doorstep at opening time w/ my child & photographs to show & insist on talking to the top.

I called the pharmacy, they said it was still denied. I called the doc's office, still denied. I called the insurance company, was put on hold, transfered & then hung up on. After almost saying "forget it" (cuz it's Friday) I called one more time, and got Caroline from the insurance company telling me that it was approved & that the insurance co. hadn't removed the "lock" on it yet. She said she was going to have that done ASAP & that it was approved for 6 more months. Yeah, it's not for a year, but it's 6 more months of not having to freak out of how we'll pay for this.

I could have reached through the phone & hugged her. I told her "you have no idea how happy you've made me today, thank you, thank you!" she was laughing but I told her how hard I've been working to get it approved & to finally hear "yes" was more than I could ask for today. Well.. I could ask for more, but I wont.

Just thought I'd share some "happy" news for a change. I'm always posting about struggles & this was a happy ending...for another 6 mos.


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September 25th, 2009, 01:46 PM
Ditzzy's Avatar Stupid Lamb;)
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That's great news!! 6 more months, Yay!!

Thank you, tasha_mae, for my siggy!
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September 29th, 2009, 10:31 AM
Daisyfields's Avatar Platinum Super Mega Mommy
Join Date: Apr 2007
Location: In the enchanted forest
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I got a call back from the insurance company & they are backdating it to August & pulling it further until August of 2010, so I'll get reimbursed for out of pocket spending on his formula "and" a longer time frame to get his formula too. This is great news for Teighan!

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September 29th, 2009, 02:24 PM
docsmomma's Avatar Platinum Supermommy
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YAY!!! So glad they are covering it, backdating it, and extending the coverage of it!
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September 29th, 2009, 05:55 PM
quietsong's Avatar Just Another Slacker Mom
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Location: Missouri
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Yay!! That is awesome!!

Visit My Blog, and come join me at the JM Blogs!
Thank you Jaidynsmum for the siggy!
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September 30th, 2009, 02:43 PM
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its about time they pulled their head out of their rears and got it together for you

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