A Letter to the CEO of UnitedHealth Group, Inc.
Update: As of 5/26/17, United Healthcare has overturned their denial, and Colton’s Omnipod will be covered under the Porter Family’s policy. Thank you to the thousands of people who helped raise awareness for Colton!
May 23, 2017
UnitedHealth Group, Inc
PO Box 14559
Dear Mr. Hemsley:
It has been brought to my attention that coverage has been denied, repeatedly, to parents Kessa and Jake Porter for their son Colton to continue to receive coverage of his Omnipod Insulin Pump. My co-founders, Juliet de Baubigny, Nick Jonas, Sam Talbot and I hope that UnitedHealthcare will re-review their request and opt to provide their 2-year-old son, who lives with both type 1 and autism, with the tools necessary to safeguard his health.
After his diagnosis with type 1 diabetes in last year, Colton’s pediatric endocrinologist prescribed an Omnipod tubeless insulin pump after considering all alternatives and consulting with Colton’s developmental pediatrician. The reality of autism makes Omnipod, a tubeless insulin pump, a critical part of Colton’s care. UnitedHealthcare approved this device and the family purchased the pump. UnitedHealthcare then reversed that decision citing, as I understand it, cost inefficiency.
Despite the substantial information and prescription provided, a peer-to-peer review with Colton’s pediatric endocrinologist and a UnitedHealthcare Medical Director resulted in the decision that an alternative pump, with tubing, would be covered. This would require the family to pay an additional $15,000 for a pump that is not advised for Colton, due to his needs as an autistic child. The family filed an additional appeal and was promised a reply on May 19th. To date, none has been received.
This process is cruel. A child now lives with a chronic, life-threatening disease and his family is tasked with keeping him safe. A doctor has prescribed medical care; UnitedHealthcare has denied that medical care and has now left this family waiting. This family deserves the technology that a doctor has indicated is critical care and UnitedHealthcare needs to honor its mission to “provide high-quality, health care coverage when you need it” and approve this request. Parents and individuals must be supported by their insurance providers as they navigate this chronic disease and the time, energy and money spent fighting for the prescribed basics could be turned to other endeavors, like living.
Sarah Lucas
Co-Founder & CEO, Beyond Type 1
