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Wed, 2 Aug 2006 10:40:19 EDT |
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Ginny has related an incident regarding an insurance company in
Massachusetts that will not cover the cost of a rental pump for a hospitalized preterm
infant. A few things come to mind:
1. can the patents afford to pay for the pump rental themselves?
2. is the mother WIC eligible or receiving WIC benefits? If so, WIC has
pumps to loan
3. the major pump companies have a limited number of pumps to loan for
mothers who cannot afford them. Check with Hollister and Medela. Also check with
local pump rental depots to see if anyone who rents pumps has one to loan in
this situation
4. the parents should challenge the insurance company ruling and ask how to
have the claim reexamined. This appeal or grievance should go through the
department that is responsible for handling appeals
5. the parents should write a letter to the CEO and the complaint department
of the insurance company complaining of the rude treatment they received
6. the parents and health care providers should fill out a complaint form
and send it to the Massachusetts state insurance commissioner's office,
informing this office of the refusal for coverage of the pump
7. the parents should contact their state representative and senator and
complain about the lack of coverage for the pump
8. you and the parents should contact the major Boston newspapers and ask
that a story be done regarding this issue (Jessica Fargen at the Boston Herald
[log in to unmask] (mailto:[log in to unmask]) and Steve Smith
at the Boston Globe [log in to unmask] (mailto:[log in to unmask]) )
9. if the parents have their health insurance through their employer, they
should complain to the employer. Some employers are self insured and just have
an insurance carrier administer the paperwork for them. The employer is
actually the one who in this situation determines what they will and won't pay for
Hope these ideas might be of help
Marsha Walker, RN, IBCLC
Weston, MA
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