I am the mother to a 4 year old boy who was born with congenital heart disease (known as Tetrology of fallot) with servere pulmonary stenosis. He has been put on Viagra (among many other medications) for the past few years to help with the heart disease. We have recently changed insurance (thru my husbands job and we pay a whoppin $200 per week). Since the change, our new insurance has refused to pay for Harrisons Viagra. It has been 3 months now and even with the cardiologist sending letter after letter to the insurance (which he really should not have to do, he should be focusing on his patient care, not writing letter after letter for my son), the pharmacy being in constant contact with the insurance (which I feel they should not be putting all of their time and energy into this situation) and getting absolutely NOWHERE. We have been paying out of pocket for the past three months for the medication ($200 for a 30 day supply) all because of the hangups that the insurance company seems to have and just cannot get straightened out. They are messing with my sons health at this point. Fortunately we have a heart fund that we use for Harrison for things that are not covered by insurance and it is all donations that we have received. At this point, the account is being depleted at a rapid rate and I am at a loss. I am sooo sick over this. I used to handle all of the phone calls in dealing with the insurance, doctors and pharmacy, but have since handed the job over to my husband because I have basically GIVEN UP. I do not know who to turn to at this point. I just want him to get the medication he deserves and have it covered by the insurance company.
This type of behavior on the insurance part really should be illegal. They are messing with the health of a person and their well-being. This is not a issue of being seen by a doctor and them not paying the claim and having to fight for them to pay. This is over a medication that has helped him over the past few years.
I understand that this is probably not the place to send this information, but I need to get this out there for people to be aware of. I am looking for some direction. Who does someone like myself contact in the government to get the ball rolling that something needs to change. And fast???? Can you help me or at least send me in the right direction???????