Thank you for all of your responses. I'm still seeking help, but am editting this discussion because I feel a little exposed having it out there. Thanks again for your support and understanding. I will let you know if I find a solution to my insurance issue (or lack thereof)
I'm sorry to hear about your problems.
The letter sounds very effective however I am not sure how much assistance an insurance commissioner will provide, as their responsibility is usually to make sure that the companies are operating according to the regulations which I would suspect they are. The current "no new taxes" environment doesn't provide much of a safety net. It sounds very unfortunate. I hope that there are some people in Connecticut who know a way around, through or over this situation for you.
Wow. Well written and it actually makes me sick to my stomach to read (which in this case is a good thing!)
A few suggestions:
First, get the part about being an insulin-dependent/type 1 diabetic up earlier in the letter. And make the statement very clear that, without insulin, you die. Make a clearer connection early on that the basics you need to stay alive and breathing are insulin and test strips.
Second, send this letter not only to the insurance commissioners (they do have some limited jurisdiction over this issue, especially if any of the rules are being interpreted incorrectly by the insurance company), but also to your local news stations, your local newspaper, your Senator, and your representative. Hell, cc: the White House!!
We type 1 diabetics represent a really interesting conundrum when it comes to health insurance and medical coverage. Our needs are so basic and immediate - without insulin, we die. If we don't have ready access to insulin, we end up in a coma first, and hospitals are required to treat us once in that state. If we don't have insurance, we end up as "uncompensated care" once in the hospital, in that the hospital doesn't get reimbursed for our care and must eat those costs (i.e., pass them along to everyone else).
Suggestion: Where does your daughter get medical coverage from? If she's falling under CHIP in your state, there's a good chance that, upon losing your coverage, you may be eligible to get coverage with her. Rules differ in each state, but look into that.
Also, I would downplay the stay-at-home mother angle. Your job moved while you were on maternity leave and going back to work would be futile because you'd basically be paying for childcare and commuting costs. That wasn't your fault and that alone (IMO) is justification for quitting. I'd fold in the stay-at-home mother part because, given your company's decision to move, it just makes sense. And someone without a serious medical condition could do that, because they would be able to obtain private coverage or wait things out (something you just can't do with T1D because of the immediacy of the condition).
I'd play down the stay at home mother part too. While I think it's admirable, I can also hear the thoughts of people whose basic bottom line is money saying that is a personal choice, if you were so concerned for your health you'd stay with your job. I think you could make a stronger point by simply saying it isn't cost effficient for you to commute and now you are at a loss and you need your health insurance, or some other kind of assistance or health coverage, without it you risk not only your health but your life, that failure to maintain control of your disease ending up hospitalized is ultimately more costly for everyone than assistance with your testing supplies and your insulin needs.
Yeah, I meant to add that too - add something about how if you don't get insulin, you WILL end up in the hospital (if not dead first). You will be in a coma in the ICU and the hospital will be required to treat you. You need to draw the connection that it's far cheaper to treat you with insulin and test strips than let you get to the point where you have no insulin and are then cost hundreds of thousands of dollars in expensive ICU care (not to mention taking up a bed in the ICU, which is a huge problem in many communities that have limited ICU beds).
I'd definately go to your local news. The power of the community can be really strong. Might not get you insurance, but it may very well lead to some pharmacy donating supplies or insulin. You never know but its worth a try.
Congratulations on the birth of your daughter. Your letter is very well written, well reasoned and effective. You have clearly pointed out the absurdity of our cobbled together system, especially as it affects those most in need. Asking a person with a life threatening chronic condition to go without insurance for 6 months is beyond understanding.
I hope your letter will do you some good. I might recommend also writing letters along these same lines to newspapers as well as your representatives in congress. I doubt the government can change the rules for you, but perhaps the pharmaceutical companies could come through for you, Publicizing your situation could help you get some action on help, you clearly deserve it.They like good publicity and abhor bad. I would emphasize their unresponsiveness. You have clearly played by the rules and should have the option of raising your daughter yourself, without endangering your excellent control. This is truly a magic time, especially in the case of a first born.
Hello, I would also add that you should call your Senators and Representative in Congress to see if they can help you. I used to work in a Congressional office and we got calls all the time from constituents asking for assistance in cutting through red tape for one thing or another. It can’t hurt, and it is their job to help you or at least direct you to another person or agency who can. Good luck!
Good luck, I've been without Insurance for nearly a decade. It's amazing how many problems diabetics face other then trying to manage the disease. It's always been said that diabetes is a "rich mans" disease and they weren't kidding. People like Brett Michaels, Jay Cuttler, Nick Jonas will never have to worry about the cost of living with diabetes which is a hardship for most.
I am sorry to hear you are in this situation. Being cut loose from insurance is a fear many of us have. You are a great writer and your letter tells a touching story. But, you want action and making someone cry won't cause a government bureaucrat to take action. What you need to do is present a situation where you have been wronged either by some insurance company, your old company or someone along the way. That they violated some rule, treated you against the law or did something wrong. Wrong not by some basic moral or ethical basis, but the violated a rule or certain contractual terms. Just because they treated you like cr*p or your situation is dire is not a reason for intervention.
Was the classification of "voluntary termination" false? Did they in fact eliminate your job and just say that to avoid other repercussions? Find a bunch of different reasons that all these companies violated the rules and press on that. When you returned, did the company refuse to offer you a comparable position under the family leave medical act? Your story is sad, you can generate empathy, but you need amunition for the commissioner to go in and slap someone. Comb the rules, try to find others who have protested. Maybe even see if some lawyer will do a preliminary meeting with you for free to discuss your "wrongful termination" or "denial of benefits."
I think the very fact that she is in this situation is what SHOULD cause the government to take action. As we all know, for type 1 diabetics, going without insulin means an immediate death. This isn't about not being able to get some sort of preventative care or a medication to treat something like high blood pressure. This is about being able to access the basic necessities to keep yourself ALIVE (as she points out, the amount of time she could live before slipping into a coma is pretty short).
There are several absurdities here - First, if she doesn't have access to insulin and test strips, she will likely end up in the ER or ICU where they will have to treat her by law (the hospital will pass those high costs onto the rest of us). Second, if she fails to properly treat herself, she WILL end up with complications (blindness, amputation, etc). If she gets end-stage renal disease, she will automatically become eligible for Medicare. If she becomes disabled, Medicaid will kick in. So, she will only get "government" health insurance once she is extremely sick and costly to take care of.
Thank you so much for your responses. I do plan on cc: the local news station, JDRF advocates, the governor, the senator. I didn't think of cc: the newspaper, but I can do that too. They've run stories on me a couple of times for my writing, so if they recognize my name, they might use that opportunity to help me out. :)
I'm trying to apply for assistance for test strips so I can possibly go without insurance and just pay for my scrips on my own (with aid). I, too, find it sickening that I have to be in renal failure or amputated in order to receive help. I'm asking to keep the control that I've achieved so I can avoid blindness (which is already on its way), amputations, kidney failure.
My husband said we should go to Mexico once a year to pick up supplies. haha. I can't believe the system is so twisted like this. I figured I'd have to pay a higher monthly rate than normal, but I didn't think it would this far out of hand. This is unbelievable. I'm dumbfounded by it. For a system that's supposed to work FOR you (that's what they say, right?) it seems to be doing everything it can to work against me.
Thanks again for your help. Please keep the ideas coming. I haven't sent this letter yet (want to make sure it's crisp and clear before I send it on its way). Give me more ammo. :)
Hi Marps,
I noticed you use Apidra, do you use pens or vial? One thing you might be able to do on a short term basis if you haven't already is I've heard there is a pen shortage of Apidra and they were offering I believe free vials for a certain amount of time for those willing to switch to vial insulin. It's definately not a long term fix, but anything to save some money as long as you can is worth something.
Your situation just proves that the Health Reform Act did nothing but protect vested interests like the insurance companies and big pharma. People with chronic life threatening conditions are simply left to fend for themselves. Perhaps things will be better in 2014 when the law is supposed to take full effect. But what are people in your situation supposed till then? Those who wish to repeal what was passed, with all its flaws, need to explain how the mighty free market can deal with these situations with even an ounce on compassion.
I believe the free market is the best way to do many things, but health care delivery is most definitely not one of them.
Do you have Medicaid in your state, because I have been receiving Medicaid for the last 10 years .
Hi Marps, I wish you the best of luck in finding help with this. Your story so clearly demonstrates what's wrong with our system. I am type I for about 25 years and fear that I will never be able to "retire" because of the cost of health insurance and diabetic supplies. Even the cost of copays with insurance is staggering. I'm basically continuing to work full time just to keep health insurance as long as I'm healthy enough to do so.
One avenue you may want to explore is to talk to your endo or CDE about free insulin and supplies. My CDE told me on my last visit that she had just seen a man who was in the "donut hole" Medicare gap and could not afford to purchase more insulin. The man was taking 1/3 of his dose of insulin each day to try to avoid running out. The CDE said she filled out paperwork and got the doctor to sign to get him free insulin but she didn't say through what program - I don't know if it was the clinic itself providing the insulin or some other program. Her comment was how was she supposed to talk to him about target blood sugars when he couldn't even get the insulin he needs to survive.
Yet our country sends billions of dollars to other countries around the world to help people there before we help our own people. It just makes me sick to my stomach.
I think your letter is well written but I agree with the advice others have given you. Move the Type I/ Insulin dependent explanation to the beginning. Make your first paragraph a summary of your entire argument, including what you're asking for, then fill in the details in the body of the letter. Most people will skim the beginning before they decide if they want to read further. Be specific and clear as to what you want the Commissioner to do for you and bring it to the top.
I would also remove the focus on the stay at home mother aspect. Unfortunately, I think you may find a sentiment that believes that if you are able to work, then you should work. Don't get me wrong, I agree with you and tried to do the same thing when my daughter was in kindergarten, only ending up going back to work after about a year because we just couldn't afford for me to stay home.
Take care and please keep us posted on how your search for help goes.
I've posted this many times on here but you can get Humalog/Novolog in Canada for about the third of the cost of here in the US. I've ordered many times and never had a problem. Sticks is another story. I know they are expensive but I don't test often so I don't spend a lot. I also believe we may see a non invasive glucose meter without supplies being needed in the next few years.
I haven't ordered on there but Amazon has some good prices on strips, Im thinking about trying it cause I need my endo to rewrite my prescription, Im running out before its time to fill them which then leads me to having to pay out of pocket. I've seen on amazon a box of 100 one touch strips around 66 dollars. Once again not a perfect solution but in the meantime maybe a way to pinch some pennies.
I also reuse my lancets too. I've been diabetic for over 28 years and have never had a problem with doing so. Before I went on my pump I'd use the same needle for my pens as well, and change out when the pen ran out. Things get pricey even with insurance. Im very fortunate mine really pays well for supplies but I can so relate to what you are saying have been many times either just no insurance and making do the best you can, or even with insurance just short on money. It's a very hard and expensive disease to manage.
That was a good idea someone mentioned about talking to your endo or CDE sometimes there are assistance programs that way as well.
I live in TX and my employer has the pre-existing condition exclusion on the medical policy too but it's only for 1 year. So next year, I'll be able to get my diabetic stuff covered. I got the exclusion because I went more than 180 days without insurance since i was unemployed and wasn't about to waste my small unemployment check on COBRA. I did get on medicaid though and that saved me alot of money. Children can not be excluded from medical coverage due to that pre-existing condition BS. The new medical care law prevents that.