Have You Sought Care Outside Your Insurance Coverage?

[Colleen Steele]

I am so incredibly stressed and upset. My son is transitioning from pediatric care at Stanford to adult care at the University of Washington. Things have been going so well! Today cardiology called to set up his first appointment and “mentioned” that as of August 1st the UW will not longer be accepting our insurance. WHAT?!

She said they will sign a single case agreement asking approval to treat Cullen. She couldn’t tell me if a whole care agreement can be signed or if each department will need to do it. I was also warned that this will need to be done every 6 months to a year. So what happens if insurance approves now but not in the future?

I told Cullen if all else fails I guess we will have to switch to back to Stanford. He made a good point though, no matter what he will still need care in WA where we live.

The UW is researching and will get back to me. I haven’t called insurance myself because I know the doctors teams are doing that at the moment and I don’t want to risk messing up their efforts.

Has anyone gone through a similar experience. I welcome advice.

[Jen Cueva]

This is horrible, @colleensteele! I know how much you prepared for this transition. e. My PH doctor of 10 plus years was leaving my insurance a few years back. We had to have my hubby’s HR team get involved. Even after all of that, they ended up only granting me a 3-month extension to see home. That was to give me time to transition. I called and found out that if I were a pregnant woman, the regulations would be different, that would be a year extension.

Long story short, the doctor and the HR team were involved, but they did not have any luck. Cigna was not going to make an exception is what I was told.

I am hopeful that you mention that UW is working and researching this for you. My Cigna case manager tried to get involved, but they did not want her input. Please do keep me posted and let me know if I can do anything. I am hoping and praying that all goes well. In the meantime, I am here if and when you need to vent. It is horrible after just finishing his first appointment, and the hospital stays with the new team. Hang in there.

[Colleen Steele]

Oh no @jenc, I didn’t know you have experience with Cigna too. It’s concerning that you have had similar problems. My husband reached out to his HR yesterday and that got back to him with a form. It sounds like it’s the one the hospital told me about. EVERY clinic will have to sign and submit. Let’s see, that would be lung transplant, cardiology, endocronolgy, nephrology, neurology and otolaryngology. With all that I don’t have a lot of confidence that there won’t be issues. I don’t know what we are going to do because even if we return to Stanford he will still need care here at home. I really can’t believe this is happening.

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