baby daddy

Your formula costs us about $560 a month and we thought we’d see if the insurance company would help cover the cost. Initially they didn’t (and as of this writing, they still haven’t), so we decided to write a letter to their appeals department because in other instances your formula is covered 100%.

Medicaid fully covers the cost. The Food Stamps program (which goes by another name) covers it. Our insurance does not cover one cent and it’s not like we can just change policies either — both your mom and I work for the state. We’re only offered one policy; neither of our policies covers your food. We’re just asking for a little help here.

We wrote this letter for you, Little Dude, because we know you’re a pretty intense guy. Were you to put your thoughts to pen, the recipient of your missive would have to recomb his or her hair when finished reading. When you write, you write in blood. When you write, you write in capital letters. All of your sentences end in question marks (but they function as periods). Don’t they? When I read what you write, it’s much like listening to what you have to say — it’s impassioned and it’s uncomplicated and forthright. It may be uncomfortable, and maybe that’s because there’s so much cursing.

That’s why we had to write this letter for you, so that the insurance company would actually read it and hopefully do something about it.

August 12, 2007

Appeals and Grievances
Blue Cross of State
P.O. Box 9876
Faketon, ST 12345

To Whom It May Concern:

Little Dude is a newborn who since birth has suffered from a milk protein allergy which makes it impossible for him to tolerate breast milk and every other hypoallergenic formula that has been attempted, to include Nutramigen and Alimentum hypoallergenic formulas.

Trial of these formulas produced a temporary and insufficient decrease in symptoms, and did not treat the root cause of his problem. Even with the use of these hypoallergenic formulas, his gastrointestinal symptoms continued, and stool showed 3+ occult blood indicating colitis caused by his allergies and intolerance to everything in his diet. It was therefore imperative that he was switched to Neocate Infant formula, which is a prescription formula and can only be obtained by Physician direction; Neocate Infant formula was prescribed for Little Dude as a medical necessity.

This prescription formula should be regarded as just that, a necessary medical treatment for his medical condition. The formula is not prescribed on the whim of the parents or doctors, and is not a dietary “preference”. To deny treatment for the cause of this baby’s colitis is unimaginable and certainly would be considered medically negligent. The cost to your insurance company for covering a prescription formula would be miniscule compared to the cost which would potentially be incurred should his gastrointestinal condition be allowed to progress. Non-treatment would result in continued and advanced colitis, numerous physician and specialist visits, hospitalization for dehydration, surgical costs for evaluation and treatment for colitis, and numerous other treatments for a prolonged period of time.

This letter is to request your reconsideration and payment for Dude’s medical care, as this is medically necessary for this child’s health. Even a partial reimbursement for the cost of this prescription would be appreciated. Enclosed are receipts for one month’s supply of Neocate Infant Formula for Little Dude. Thank you for your reconsideration in this matter.

Sincerely,

Baby Mama & Baby Daddy

As you can see, we wrote this letter about a month ago. We received a letter in the mail saying that their appeals department would take up to 30 days to reconsider their original ruling, so we’re still waiting. In the time since we began this new formula, you’ve turned intoa completely different kid, man. You’re an absolute angel. That’s not just some mushy dad talk; you’re a darling. You’re a smiler and a giggler, and you’re constantly happy. If I could hug the Neocate company, I would.

About a week ago we did get a check totaling $2, but I think that was for another prescription. If it was the help they sent for your formula, though…well, I think we’d just send you in to do the dirty work.