Letter to insurance company regarding denial of care.

I wrote this comment in the comment section on a Facebook IVIG group of a patient who had had their IVIG denied by an insurance company…the fuckers.

Insurance has no business denying medical care. If they want to limit what they will cover, fine, but they need to be upfront about it before we sign up. Denying medical care after the fact is like saying ‘I don’t see a fire, there is no fire’, when half of your house is burning down.

It is morally repugnant, and should be legally repugnant as well.

(My letter writing skills are not up to snuff, but this patient seemed so sad and overwhelmed by the denial of IVIG therapy, I just wanted to help…)

***

Letter writing, letter writing. The fact they mentioned pain, that’s good because what’s ‘pain’ is in your department.

You must write a letter in response to their refusal, and you must CC your physicians (and an attorney if you know one, even an attorney friend is okay).

Suggested letter (just to help–I’m not sure if this is the right letter for you, but just an idea 🙂

***

Dear Insurance,

I received your notice regarding the cancellation of my IVIG therapy, which is a mistake that I’m requesting to be fixed immediately.

IVIG therapy has greatly improved my quality of life, including I’ve regained movement and feeling throughout different places on the entire left side of my body — this is a major improvement in my medical care. This improvement in my medical care has been noted by my physician, (name), who has been overseeing my care since (date).

In regards to your reasoning of denial for IVIG, that I’ve had ‘no improvement in pain’ [quote *exactly* what they wrote], this is not factually correct, and therefore not a legitimate reason to deny IVIG. I have had significant improvement in my pain levels since beginning IVIG therapy. It is correct that I still need pain therapy, but it has been much reduced.

I am requesting a correction in this oversight in my care and that you will approve the continuation of my IVIG therapy immediately. By denying IVIG therapy, you are endangering my health and forcing me into unnecessary (and cruel) pain and suffering.

As stated on your website ‘we provide healthcare for all Americans’ [get a good juicy quote on how their company promises to take care of the medical needs of their prescribers], I hope that you will live up to this commitment, and correct your mistake on my medical case by restoring my IVIG therapy immediately.

Regards,
[your name]

Cc: your doctor, an attorney if you know one, anyone you think might help.

The Cc is very important, because you’re letting them know you mean business and are involving other people, which helps to strongly legally document your comments.

About hopeforanswers

Some kind of rare immune deficiency, yet to be determined. A lifetime of infections without an elevated white cell blood or fever. Very grateful to be alive, very thankful for the friends who’ve supported me and for access to literally millions of dollars worth of medical care. I’m not the bubble child, I’m somewhere in between.
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