United Healthcare Complaint - United Healthcare Denies Much Needed Medication
I no longer find it shocking the lengths insurance companies will go to deny claims, I find it numbing.
Today Mike was denied his appeal for double dose Cimzia from United Health Care. The reasoning, 'medication is used at a dosage determined by us to be experimental, investigational, or unproven.' hmmmm If we do not experiment, investigate and try to prove then we become less then sloths in our society.
The case was determined by a pharmacist for the insurance company instead of a Licensed MD.
The letter was written to Mike with a tone implying he himself had decide to up the dosage of his meds. Not mentioning the Specialists whom have requested the dosage increase. They did c. c. the Miami Specialist.
Mike lives his life in a Crohns Flare regardless what meds he is on. He is on the toilet more times before 8 am then some of us go in a week. That is just the first round of the day. He is a sick man who constantly has to fight the system because of his illnesses. Which of course makes his over all health worse.
I am disgusted in our system. It sickens me that our government lets sick people go without medications, procedures, and funds at the hands of the insurance giants that rule the lives of unhealthy people paying them a monthly premium.
We have been left with our hands tied because of ERISA. Our government refusing to change these laws proves even more the stronghold insurance companies have over them.
So, here we are again. Another insurance company that we are paying controlling Mikes health, or lack of. Luckily he has a great staff (yeah staff, that is what it takes to try and control his illnesses) scrambling around trying to find a medication so he won't die. That is not drama, that is the truth, just ask Dr. Trope. He is from South Africa and still cannot fathom how when he writes a script it is not honored. Or ask Dr. Kermen down in Miami. He has his staff trying to find an alternate for Mike. Or you can ask Dr. Mackie, she is meeting us on Tuesday, trying to find Mike something to not let him fall into a depression. Or ask any one of the nurses who have been so kind to Mike. They all say our insurance system sucks.