I have been following a petition on change.org created by a woman with a three-year-old daughter who relies completely on prescription nutrition to survive. Due to her medical condition, she cannot eat. The problem is, the parents' health insurance won't pay for the formula and it is pretty expensive. The mom says it costs her about $1,400 a month.
Because both parents are employed, they can't get government assistance so they struggle to pay for the nutritional formula for their little girl. The petition has been up for a while now and has about 200,000 signatures but United Healthcare hasn't reversed their opinion.
Before I started writing full time, I worked for two different insurance companies. I went through a pregnancy with both companies. When I worked for Humana, the head of the customer service department gave me a hard time about taking time off to go to the doctor. When I need Zofran to prevent dehydration, Humana offered me ten pills every month. My doctor filed an appeal for me and they gave me 12. Fortunately, my doctor had samples and gave me all she had to keep me out of the hospital.
With my next baby, I worked for United Healthcare, the same insurance company the woman with the little girl who needs prescription formula has. I was hospitalized six times in first five months of my pregnancy for hyperemesis. United Healthcare was more generous than Humana and gave me 40 Zofran pills a month. They had no problem paying for me to be in the hospital for two days at a time when I got dangerously dehydrated though.
In my experience, insurance companies' decisions are not made by real people with real illnesses. To get what you need from your health insurance, you have to know how to work around their policies. According to the petition, there are 10 states that mandate insurance companies to pay for formula. If I was the mother in the petition, I would move.