In the US today, Health Care has become extremely complicated. Even more so, the logic of decisions that insurance companies make are, well, illogical! Let me paint you a brief picture.
If you are reading this, you probably have spent some time on the blog and know that Anna has been getting her treatment at Maria Fareri Children's Hospital in Valhalla NY. You also know that a 9 year old battling Leukemia is braver than any adult could be. Now while Anna is the bravest little girl you could ever meet, she also is still only 9 and has become accustom to the "New Normal". She is used to the frequent friendly faces at MFCH and the Clinic. In fact I know how comfortable she is based on a statement the night of her seizure, while at Norwalk Hospital. Anna said "I want to go to my hospital." I applaud all of the health care professionals that have made our little girl feel as if their hospital was her home away from home.
Ok, so here is where modern insurance makes no sense. Just in the past few days Anthem Blue Cross Blue Shield has advised that they are "Denying" Anna's bone marrow transplant. Why you ask?
Perhaps it's because Anna is on some experimental treatment plan?......NO, she isn't
Perhaps it's because we have exceeded our yearly expenditure?.............NO we haven't
Perhaps it's because all of the Dr's Anna has seen since her diagnosis are not covered by the insurance?.....NO that's not it either.
It is because Anthem BCBS has a list. And on that list it doesn't not have MFChildren's Hospital as an "Approved Transplant Location"
So what does that mean? it means we can choose a hospital and a team of doctors, who do not know Anna, who have not been administering Anna's treatment, who do not understand how to relate to her, who look at her as patient ABC123, where Anna knows no one, where our family has to spend a 6-8 week time period away from home and work in a location that is more inconvenient and add additional stress to our lives during an already extremely stressful time. But I guess that's just the way to rules are now written.
Well we are not standing for this. Anthem BCBS needs to now, that not only are we going to Appeal the decision, but we are Also in touch with The Leukemia & Lymphoma Society, Connecticut Department of Insurance,