Social Media Forces Insurance Company’s Hand
As a parent you plan to give your children every opportunity to live a happy, healthy life as you spend each day watching them grow and learn. My 2-year-old son Colton was diagnosed with T1D on August 22, 2016. A few months later we received a diagnosis from a pediatric specialist that Colton had autism.
The T1D diagnosis was a shock with a steep learning curve. The day-to-day struggle of carb counting, lunch packing, juice drinking and activity monitoring is enough to fatigue even then most devoted parent. On top of the near constant sugar checking, my wife and I were tasked to identify and monitor the signs and symptoms of a non-verbal 2-year-old with autism.
After many sleepless nights struggling with lows and having many fights with Colton about injections, his endocrinologist agreed pump therapy could help managing his diabetes much more tolerable. A few concerns and red flags immediately popped up. Colton, for the most part is limited in his ability to alert us when he is facing a spike or a low. Compounding the issue is that without restraining him for a shot or waking him up for a correction in the middle of the night meant he was consistently running dangerously high.
The second concern was that he will not tolerate loose clothing, belts or tubes touching his body. This limited our options drastically and helped us identify the Omnipod as best option for Colton. A short time later we began using the cordless pump and noticed a dramatic difference. We could manage his highs and lows from a distance without fighting a mercurial toddler, and more importantly turning Colton into a pin cushion. By using this pump we could issue a correction without an injection and without disturbing the precious moments when Colton is asleep.
We were finally seeing some improvements and stability when a change in insurance provider became a reality. In an effort to circumvent any disruption in Colton’s treatment or supplies I reached out to United HealthCare approximately 90 days prior to open enrollment. On at least three separate occasions I spoke at length with staff rom United HealthCare about Colton’s pump, supplies and coverage. At each instance I was assured that there would be no problems and they would be happy to continue with Colton’s care and cover his Omnipod supplies. Having been assured that coverage was going to be there a few months later we had new health coverage. As the diabetes management became a better managed routine we contacted our DME supplier to initiate a refill of his pods. A few days went by and no supplies arrived so I reached out to the supplier and I was informed that United Healthcare denied coverage for his pods. I was heartbroken and furious as I was assured multiple times a few short months ago that his pods would be covered.
I reached out to Colton’s endocrinologist and asked that she intervene. She quickly contacted United Healthcare on our behalf and scheduled a peer-to-peer review with a medical director at United Healthcare. The outcome was infuriating; he has in fact denied the coverage again based on cost effectiveness. This person has no knowledge of Colton, his treatment, his complex health issues, the autism. No, the decision was made solely based on money. This is the day that United Healthcare put a price tag on my son, and in turn lit a fire in the stomach of his dad.
As I lay awake into the morning hours imagining how to overcome this battle with United Healthcare, I began to recall some information we were given upon arrival to the hospital. One of the things was a crash course in resources. One of the resources was a mobile app called Beyond Type 1. The day we left I downloaded the Beyond Type 1 mobile app. I was hoping that I was not alone so I created an account, introduced myself and began reviewing many stories of parents with similar concerns. The support and advocacy from other parents and staff is second to none. I also remembered that three days after Colton was diagnosed, we were sent home with a list of resources that included contacts from JDRF, Omnipod and several other advocacy groups.
I did what any parent filled with rage would do. I contacted every advocacy group I could think of asking for suggestions, advice and support. I received responses from staff at JDRF and Omnipod. Morgan, Alissa and Steve conferenced with me from Omnipod and Alissa reached out to Thom at Beyond Type 1. A typically private person, I tend to keep family issues to myself, but something about this was different. This was not a joke; this was Colton’s health being put in jeopardy because United Healthcare saw cost before customer. A few tense hours go by and I was contacted by staff at Beyond Type 1. I was able to share my story with Thom and Sarah and they created a campaign for Colton on social media that could not be ignored. I continued to work with them in the coming days to increase awareness and apply pressure on United Healthcare.
The next day, I contacted United Healthcare and let them know I was prepared to do whatever it takes to get them to honor their obligation and cover Colton. During this time social media exploded with the Beyond Type 1 #CoverColton Campaign across multiple platforms. The next day we received word that United Healthcare had reversed their decision and would be providing coverage for Colton. I am elated and grateful for the support, beyond what my simple words can express.
I believe that the advocacy from Beyond Type 1, Insulet, JDRF, Cooks Children’s Hospital and the caring T1D community made the difference in the fight with United Healthcare. I will forever be in awe of the resounding voice the T1D community has and will always promote advocacy from organizations like Beyond Type 1 within the T1D community.
As a parent I am ready to wage war to protect my family. As a member of the T1D community I know that I won’t face the battle alone. Please use your contacts, advocacy groups and partners to help you find strength and solutions in your time of need. We will be here when you need us. NEVER GIVE UP.
Read the letter to the CEO of UnitedHealthcare from Beyond Type 1 CEO Sarah Lucas.