Anna

[Angelo]

Below are two photos of my granddaughter Anna. On November 1st she was diagnosed with Leukemia. On November 5th she turned 9 years old.

Just before the holidays she was pronounced "in remission" so she had only 25 months left of chemo. A week ago we were told the cancer was back and she would have to undergo at least two more bouts of chemotherapy before a bone marrow transplant.

I would give my heart if it would heal her but it wouldn't. So I can only do the next best things, pray and try to raise money to pay for her treatments. With insurance my daughter can expect to pay about $20,000 in uncovered costs.

I am trying to help raise some of that by turning Holiday ornaments. You can see them in the members gallery. If you can help please do. If you can pray please do that too.

You can follow Anna's journey at http://821foranna.blogspot.com/

Thank you for your kind consideration

Angelo

 

[Bill Boehme]

Thank you for telling us and I'll do both of the the things that you request.

 

[Bill Boehme]

Angelo, it was brought to my attention that some newer participants on this forum do not know your last name or that you are a past president of the AAW and therefore don't know how to contact you. I don't want be presumptuous by handing out someone else's personal information on this forum.

 

[Angelo]

Thank You

Bill,
Thank for you support and the heads up.
I am Angelo Iafrate. My email address is ajiafrate@me.com. Or you can contact me thru this forum by sending a private message
You can send me a private message by clicking the blue hypertext "Angelo" above. You'll see a drop down menu with "private message" being one of the choices
Angelo

 

[Breck Whitworth]

Angelo I will be praying for your granddaughter, I am so sorry to hear about this horrible disease that has come upon her. She is a truly beautiful young lady.

 

[Angelo]

What's wrong with this picture?

Here is the newest twist.

Ok, so here is where modern insurance makes no sense. Just in the past few days Anthem Blue Cross Blue Shield has advised that they are "Denying" Anna's bone marrow transplant. Why you ask?

Perhaps it's because Anna is on some experimental treatment plan?......NO, she isn't
Perhaps it's because we have exceeded our yearly expenditure?.............NO we haven't
Perhaps it's because all of the Dr's Anna has seen since her diagnosis are not covered by the insurance?.....NO that's not it either.

Maybe someone out there with more insight can provide some guidance?

Thanks Angelo

 

[Bill Boehme]

Here is the newest twist.

Ok, so here is where modern insurance makes no sense. Just in the past few days Anthem Blue Cross Blue Shield has advised that they are "Denying" Anna's bone marrow transplant. Why you ask?

Perhaps it's because Anna is on some experimental treatment plan?......NO, she isn't
Perhaps it's because we have exceeded our yearly expenditure?.............NO we haven't
Perhaps it's because all of the Dr's Anna has seen since her diagnosis are not covered by the insurance?.....NO that's not it either.

Maybe someone out there with more insight can provide some guidance?

Thanks Angelo

I can't say that I have more insight, but don't accept the insurance company's decision as the last word. You and I both know that it is all about money and nothing to do with the medical aspects. I have had to butt heads with insurance companies numerous times for my parents as well as myself. Some of their stunts include:

• Playing dumb where they are obligated to cover a procedure, but deny the claim hoping that the insured will pay for it out of pocket or just go away. It apparently is successful often enough that they use it as one of their standard practices.
• Incorrectly determining the amount that they will pay (same rationale as above). This is especially prevalent if there is more than one insurance plan involved.
• Dragging their feet and being unresponsive. It isn't easy to push on a rope to make progress, but do it anyway.

If you haven't already, involve the doctor's support by providing documentation for the medical necessity of the procedure. Most hospitals have personnel who can help with getting stubborn insurance companies to cover medically necessary procedures. Go through the appeals process. Make them explain in detail why they say that they are not covering the procedure. I'll try to come up with other suggestions.

 

[Mark Mandell]

Angelo,

You (and your family) need to contract the RI consumer health insurance help office http://www.rireach.org/

They will have information on your options and what you need to prepare for this fight.

Don't forget your ability to generate bad PR for the company, just have your "tools" sharpened before you go down that road.

 

[Jerry Bailey]

So sorry to hear about this
is especially sad that a child has to endure such a disease and rough treatment regimen

Angelo, as with Bill, I have had numerous experiences with insurance, especially Anthem Blue Cross
you should know it's standard procedure for them to deny claims initially, especially if they are expensive treatments
You should have also received info on how to appeal this decision .....
You need to go through the appeal process and start it immediately,
you might have to appeal 2-3 times, but eventually they will cover the costs/treatments needed (especially if they have done so in the past)
Blue Cross is hoping you'll just accept this and pay yourselves ..........
(I've had to appeal twice in 1 case, and then they finally paid for the treatments/procedures I needed)
This is the effect when Health Care is a profit type organization, they hate to pay out any monies they don't have to.

Prayers will be said for Anna

 

[barbsiddiqui]

Angelo, I can't imagine having to go through this. Wishing your family all the best, and I hope you can put enough pressure on the insurance co. to force the situation. God's speed.