Last year, for the first time in my long illustrious career as a health insurance company premium payer, I needed a small medical procedure. So imagine my surprise when I was denied. "Deemed medically unnecessary," said my rejection letter. Imagine my surprise that a health insurance company could override my doctor in what was deemed medically necessary. Luckily, this wasn't a life threatening condition -- just one that was making my life extremely uncomfortable. But imagine getting that same letter when your life is on the line. That's what happened to 18-year-old Lorelei Decker, whose insurance company, Blue Cross/Blue Shield, rejected her bid for cancer treatment. But this time the health insurance bigwigs were messing with the wrong teen.
Lorelei suffers from Hodgkin's lymphoma, a cancer of the lymph node system. Lorelei's cancer has been resistant to chemotherapy and now she has a tumor in her chest. Doctors suggested a last ditch stem cell transplant. But then the BCBS rejected this treatment as "medically unnecessary."
I can see it both ways here. If you're a company, and your main concern is the bottom line, then paying for expensive treatment that may not work isn't optimal. But if you're a patient or a patient's family, of course, you say, "Give me whatever you've got!" End of story.
After the rejection, Lorelei and her mom took to Twitter. Lorelei's mother, Andrea Decker, sent out the first salvo, tweeting:
All hell's about to break loose. BCBS DENIED Lorelei's transplant. No words for how angry I am. I guess it's cheaper to let her die.
The family started the hashtag #ApproveLorelei. Several hundred people retweeted and used the hashtag to express their outrage. Soon it was trending in Oklahoma, where Lorelei lives.
By the next day, the insurance company had suddenly changed its tune about Lorelei's treatment being "medically unnecessary." Imagine that! Lorelei thinks the change of heart came solely as a result of the attention surrounding her case. She says:
Typically people don't fight on social media or don't publicize the issues that they're having issues with insurance coverage, and it's just up to them to call and reapply or mail it in, and it's all on them. But when there is a level of publicity there, there's a level of urgency to defuse the situation, and so you're kind of put on the front burner, finally.
So maybe we all need to take to Twitter the next time we're denied medical care.
Have you ever fought your insurance company?
Image via LoreleiDecker.com
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