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Thursday, July 7, 2011

DISAPPOINTING NEWS . . .

My heart and my mind are so full.  July 01, 2011 marked the one year anniversary of Glen's diagnosis.  We have been down many valleys and up just as many hills in our journey looking for, applying for, fighting for treatment for Glen.  One day I will be able to write about all of that but for now I just need to vent my frustration.

Glen began treatment in September 2010.  At that time we had no insurance.  After paying premiums for four years, to find out your policy doesn't offer the coverage you need is not a good thing.  Glen did apply for and was approved for the high risk insurance pool through the state of Utah.  There was a six month pre-existing waiting period.  During this time he received treatment paid for through financial and drug assistance programs as we also lost our income with Glen's diagnosis.  The treatment proved to be effective.  By the time the insurance did kick in in February of this year Glen was ready for a Stem Cell Transplant (SCT) so we made the decision to have this treatment at the Huntsman Cancer Hospital in Salt Lake City, Utah.  Another decision was made to place Glen in a study due to the fact that he has a protein deletion and his doctor recommended trandom SCT.

And so it all began.  First, by getting the transplant approved for by the insurance company.  It was explained to us that even though the doctor is wanting two transplants to happen, they have to be approved one at a time.  Get the first one done, take a look at the results, then submit a request for approval for the second transplant.

DENIED!  We received a letter, a full page long, basically stating:  "because of the protein deletion you are considered too high risk"  (not the exact words).  So  an appeal was immediatly submitted.  Today, after about a six week wait. the news came once again.  DENIED!  HOW CAN THEY HAVE THE POWER TO MAKE SUCH A DECISION WHEN IT COMES TO SOMESONE'S  LIFE?

Part of the explanation for denial was that there is no data available that proves a trandom transplant to be any more effective than one.  My answer simply:  there isn't going to be any data if the procedure doesn't happen and no documentation is made.

I am grateful that Glen has the insurance coverage that he has.  Without it he would not have gotten to have a transplant at all.  Please Heavenly Father, help us to be strong.  Help up us come to some understanding as to why this decision has been made.  Help us to move forward in a positive manner.  We thank Thee for each and every day.

Vannette

2 comments:

  1. Hi Vannette- I am so sorry for all the crazy insurance trials you and Glen have been put through!!! Should not be allowed!!! I am very blessed to have full inclusive coverage for all my Myeloma treatments and your posting underscores just how fortunate I am. Keep petitioning, keep fighting, writing... there is so much research out there documenting the necessity of Myeloma specific chemos, SCT's etc. Join clinical trials too. Fight on! Stay strong, and I wish you and Glen the very best in his treatment process journey!!! Julie

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  2. Thank you Julie. I so appreciate the support I gained by communicating with other MM patients and caregivers. We have learned that we can still approach the grievance committee before all is settled. I'm new at this blogging thing but I am going to try to keep things updated. Thank you, again.
    Keep Strong,
    Vannette

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