Edmonton Child's Lifesaving Diet Falls Through Cracks

[karrie]

The Caskennette family of Edmonton Alberta are facing $1000+ monthly bills to feed their weeks old son, after a deadly allergic reaction to a plethora of proteins has eroded his bowel drastically. Having spent much of his young life in hospital already, doctors have prescribed the only food possible to help stop the damage and ensure that his ravaged system gets the rest it needs, a pricey amino acid supplement called Neocate. The family were relieved to finally have an answer, but crestfallen when it became clear that this lifesaving diet, is not covered under their insurance plans. They've exhausted every avenue, and are faced with the possibility of having to sell their house in order to feed their son.

It boggles my mind that when it is life or death, the insurance companies can weasel their way out of covering this.



Edmonton couple foots $1,000 monthly bill after hypoallergenic baby formula is rejected for drug coverage

 

[SLM]

What an absolutely heartless decision on the part of Blue Cross!

Insurance companies have no equal when it comes to inhumane decision making.

 

[Goober]

Here is the Premiers email address and what I wrote - along with the news story and link.

Government of Alberta Premier contact

Adds are running on radio asking for input on the new budget.
This is a case where time is of the essence and time for positive and a quick reaction by the Alberta Govt.

 

[TenPenny]

In NB, we don't have catastrophic drug coverage, there's a guy here with brain cancer, and Avastin costs about $10,000 per month.

 

[karrie]

That's revolting.... 10, 000 a month... I can only guess what the cost to manufacture it is.

What I find frustrating is that this family DOES have coverage, they have prescription coverage, and they have a prescription in hand.

 

[Goober]

That's revolting.... 10, 000 a month... I can only guess what the cost to manufacture it is.

What I find frustrating is that this family DOES have coverage, they have prescription coverage, and they have a prescription in hand.

Insurance companies will use every way possible to avoid paying. I have more use for used car salesmen/women than I do for Medical coverage from Insurance companies

 

[SLM]

That's revolting.... 10, 000 a month... I can only guess what the cost to manufacture it is.

What I find frustrating is that this family DOES have coverage, they have prescription coverage, and they have a prescription in hand.

They are saying they know better than the doctor, because by denying the claim they are essentially saying what the doctor has prescribed to treat his/her patient is not a prescription. But who would know better what should be prescribed to treat an illness than a doctor?

 

[TenPenny]

All insurance companies decide what drugs they'll cover. Many will only cover one cycle of fertility treatments, and most won't cover the expensive cancer drugs.

And think about it, this is Canada. You want to think about what it's like in the US? I have a cousin who is a doctor, he lives in Arizona, he works for HMOs. He reviews patient files, and decides what the company will cover, and what they won't. It's ugly.

 

[Goober]

That's revolting.... 10, 000 a month... I can only guess what the cost to manufacture it is.

What I find frustrating is that this family DOES have coverage, they have prescription coverage, and they have a prescription in hand.

Use the example of aspirin - it is over the counter- If you have a heart attack the prescriptions include 81 mg aspirin along with a host of other meds-I know as i now have a prescription for this and it is covered. If on a prescription it is covered by a medical plan. So why can do they differentiate on this.

Cancer patients are prescribed Boost when receiving treatment - and then it is covered. Yet it is also over the counter.

Perhaps a call to the Superintendent of Insurance, Federal Office would be a plan of attack.

 

[shadowshiv]

What an absolutely heartless decision on the part of Blue Cross!

Insurance companies have no equal when it comes to inhumane decision making.

Insurance companies never want to pay anything out, they just want to get the money from people! They always seem to try and find loopholes so that they have a "reason" that they don't have to pay. I find it quite dispicable behaviour to be honest. Greed, plain and simple.

 

[SLM]

Insurance companies never want to pay anything out, they just want to get the money from people! They always seem to try and find loopholes so that they have a "reason" that they don't have to pay. I find it quite dispicable behaviour to be honest. Greed, plain and simple.

Yep, the closest thing to pure evil we have on earth, I'm pretty sure.

 

[shadowshiv]

Yep, the closest thing to pure evil we have on earth, I'm pretty sure.

Pretty close, I would say. Potentially witholding needed medicine to save a life, particularly that of a child, because it would cost your precious bottom line, is disgusting behaviour.

 

[SLM]

Pretty close, I would say. Potentially witholding needed medicine to save a life, particularly that of a child, because it would cost your precious bottom line, is disgusting behaviour.

I actually wasn't being facetious, lol. I know that's a new one for me.

So many people pay into the policies, only a portion of those ever really make substantial claims. They lose nothing by paying out in these cases, not really.

It is pure greed.

 

[Praxius]

Our son is on that formula, which is government funded here in Australia. For eight tins, we pay aprox $33... With my wife's concession card, we only pay $8 for the eight tins (going from memory) We get it funded by the government due to being prescribed by our doctor..... Without the support, we would be facing about $400 for the eight, give or take.

We go through one tin in about 2 - 2.5 days. This was mostly related to our son being born 3 month premature and had a few development issues with his digestive system, which he is gradually growing out of.

The fact that this family has to go through this situation on their own and the government won't actually step in to help out is pathetic, petty and just damn cheap. It shouldn't even have to go through private insurance ffs.

If the Aussie Government can cut parents some slack in helping their children have a chance at eating their well needed food without vomiting it up 15 minutes later, having green pasty sh*ts that is full of rejected nutrients that turns their arse red, they can't gain any of their well needed body weight & grow properly and end up screaming and crying for hours on end due to being in pain the whole damn time..... WTF is the Canadian Govt's fk'n excuse?

Try dealing with that situation yourself and tell me that's perfectly fk'n fine to go through.... While ending up in the poor house in the process like these parents are.

We at least didn't have to end up worrying about the cost to keep our son alive.... Kind of glad we moved here knowing this, otherwise we'd be screwed and if we weren't on the streets by now,our son would be dead, because that sh*t expensive and there's no alternative.

We and the doctors tried everything and the Neocate was the last option available to allow our son to get the nutrients he needed to grow & develop without vomiting it up and suffering constantly from stomach pains.... Even then, after weeks of trying this and that & putting him through all this, he still had a week or two to go before things settled down.

With the attention he and my wife needed during that time, I ended up walking from my job so I could spend a few extra days helping them out, as it was almost 24 hours a day care for him and no sleep...... Which my d*ckhead boss didn't seem to grasp when I asked for a Friday and Monday off without pay.

So I walked and took two weeks off to help, then found a better job.

If we had to worry about paying full price for the formula on top of all this, we'd simply be fk'd.