Tag: Humana

 SCORE ONE FOR THE DIABETES COMMUNITY TONIGHT.  I was contacted by Esme’s mommy, Faye, tonight and she informed me that not only were Esme’s diabetes supplies approved by her insurance company tonight but Humana Insurance Company apologized as well.

Little Esme captured the hearts and involvement of the diabetes community on Thursday when it was reported that she was denied a total of six times from applications and appeals to obtain a CGM and an insulin pump by her mom’s insurance company.  Esme was diagnosed in February 2016 and her pediatric endocrinologist rallied for Esme’s welfare to have the proper diabetes management tools.  After the word got out and the facts appeared to present the case as just a series of miss-steps in the insurance process leaving a two-year-old to receive the bulk of wrong doing,  the diabetes community reacted in full force.

Faye wrote to me, “We know that social media and the advocacy work done by so many (especially BeyondType1.org) played a HUGE part in the quick turn around of Humana. In fact, I am pretty sure we not have gotten the same result alone. We are so grateful and look forward to continuing our efforts to obtain long-term change for all families.”

For those celebrating the Jewish Holiday tonight, one person wrote to me and called it a “Passover Miracle”.  The job is done.
You did that.  To all those who wrote an email, you changed a life tonight.  You changed that life for better, forever.

Not bad for a day’s work.  Good job Diabetes Community……good job indeed.

Shalom.

I am a diabetes dad.
Please visit my Diabetes Dad FB Page and hit ‘like’.

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……THIS is something we can do something about; and now.  We need to speak up when we can…….today is such a time.

This story came to my attention via my friends at Beyond Type 1; I wanted to find out a little more.

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 can 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 done.  Application done.  Docs approval 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, 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.”

REALLY!

Enough……this is sickening.
If I have ever asked you to do something please, make this the thing you respond to; send Humana’s CEO Bruce Broussard an email and just ask for a fair hearing to save Esme’s life.  Email Mr. Broussard via email bbroussard@humana.com.  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 on Friday.  Why should a two year old little girl get caught in this nonsense?  She shouldn’t.

Send the email tonight.  Help change a life.

I am a diabetes dad.
Please visit my Diabetes Dad FB Page and hit ‘like’.