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Re: [IP] Fw: Insurance denial

Comments to add to your list.

> > And as long as I had them on the phone, I asked them why he had been
> denied  and get this----"there is certain criteria that must be met, for one thing
> > he is under the age of 12 (age!!!) and his diabetes is under control at
So there is an age discrimination issue?? My recollection is that 
pump protocol is in place for patients as young a 5 years old. Don't 
remember where I saw this unfortunately.... it is beside the point. I 
assume they have started to practice medicine in overuling Taylors 

> this
> > time, his last A1C was 5.2, but he is coming out of the honeymoon stage
> now.

good hbA1c's are an indication of a patient that works hard at
control and is a GOOD candidate for a pump, not the other way around.
They need to understand that (they do, but tell them again).

> > I didn't reply, but I thought--so you are telling me my son should be
> > non-compliant and then you may consider it!!!  As I said before I will
> share
> > the letter, glean everyone's wisdom, and if all else fails, I will get the
> > attorney after them.
Start with the appeals process. That will probably work. Lily is 
insured under BC/BS as are many other list members with kids. There 
are a common set of standards I believe. Next move to the insurance 
commissioners office then the attorney. Just let them know what you 
will be doing. Also do your very best to involve the press.

Also contact your congressmen's and senator's offices. They eat this 
stuff up. it's good for them because of all the interest in insurance 
problems in the electorate.
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