Approve Free Durable Medical Equipment for Patients Through Health Insurance
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Hi! My name is Lauren and I am 27 years old. I was born with a congenital heart defect. I went into heart failure for the first time before I turned 3 years old and spent my 3rd birthday in the hospital recovering from open heart surgery where I received an artificial mitral valve. At the time, I was put on a blood thinning medication called, "Coumadin" or "Warfarin (generic)". Little did I know, I would need to be on this medication for the rest of my life....
Since then, I have had another open heart surgery to replace my artificial valve, went into heart failure, again, and even suffered a heart attack! I have a St. Jude Mitral Valve which is made out of metal and cannot take any other blood thinner except for Coumadin/Warfarin. Therefore, anti-coagulation therapy is required long term. Everyday I live in fear of having another serious heart event happen to me and ultimately taking my life.
Antiocoagulation Therapy Consists of:
- Taking Coumadin/Warfarin Daily
- Getting Daily, Weekly, or Bi-Weekly blood draws
- Monitoring the amount of time it takes for my blood to clot (PT/INR)
- Constantly adjusting Coumadin/Warfarin dose to achieve optimal PT/INR range
It is CRITICAL to constantly monitor someone's PT/INR range because there is an optimal and safe range that the patient must be in at all times. So, Coumadin/Warfarin is constantly needing to be adjusted in order to tailor to the patient. A PT/INR range that is above normal can cause someone to bleed excessively. A PT/INR range below normal does not prevent the formation of blood clots which can lead to Pulmonary Embolism, Deep Vein Thrombosis, Heart Attack, and Stroke. I have not been able to maintain or even obtain a safe PT/INR range for several years. Because of this, my body forms blood clots on my artificial valve which either stay there, causing my valve to malfunction and not work at 100% (Cardiac Heart Failure), or the clots break off and travel to other parts of my body including blood vessels (Heart Attack). All of this includes several regular follow ups with a cardiologist to monitor progress, or repeated admission and lengthy stays at the hospital, which essentially costs the insurance company AND the patient MORE money. Regular doctor visits and hospital stays can also have a negative impact on an individual's employment status as they are constantly missing time to attend to their health needs. Some may even lose their job. Children that have to endure this risk missing valuable time at school and their parents miss time from work as well, which can have a massive impact on their financial and employment status.
***There is a device that allows one to monitor their INR at home, by pricking their finger, drawing a VERY tiny sample of blood, and testing it on a special machine. This technology allows someone to monitor their INR as frequently as their doctor recommends without having to go to a lab, medical office, or hospital which can incur copay's and fees. It is also extremely convenient for individuals and children who have a fear of needles or difficulty with blood draws due to the size of their veins, etc.
The machine typically costs $2,000.00-$3,000.00 and supplies (lancets and test strips) cost approximately $100.00+ monthly.
My insurance company has denied my physician's request to obtain this machine. They do not find it "Medically Necessary." Even if approved, they may not pay for the full cost leaving me to pay 50% or more out of pocket. I have health insurance, but imagine what the cost would be for someone in this same situation who does not have health insurance. Or consider the financial hardship on families who have a child with a heart condition and still cannot afford this equipment for them after assistance from insurance.
I am asking for your support with this petition for myself and other individuals in the same situation to make it possible to get the devices we need to maintain our health.
I hope that you can see just how important this technology is and how detrimental insurance policies can be to someone's life. Healthcare has made some strides over the years for example, diabetes supplies are now much more accessible and affordable to patients, and leave them with minimal to no out of pocket costs. So let's get this same policy adopted for patients that need anti-coagulation therapy!
Please sign and share this petition so that we can move towards making a positive change and either make this type of durable medical equipment free to patients or of EXTREMELY little out of pocket cost!!!
Thank you! xo
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