Insurance cut off my medication and I have suffered greatly for it.

Location: Orlando, FL

Hello,
This is my story, and boy does it suck.

So I have an auto immune disorder, ulcerative colitis. I had been on a good medication since Dec. of 2019 that kept it under control. I started my current job in June of 2023 and took the insurance coverage that came with it. Blue Cross PPO.

In Nov. of last year I called my doctor and he put in a refill request. Blue Cross denied it without giving any reason. My doctor kept appealing it with no reason as to why it was being denied and making no effort to put me on any other medication. Back and forth all this year I got no answers, and no medication.

On June 3rd I was speaking to a specialty condition nurse advocate, a service from Blue Cross, and they got me connected with the department at Blue Cross denying my medication. They said there were four other medications that I had to fail before they would cover the medication I was taking for almost 5 years, that they had approved the refills of for 18 months after I started my job. The rep had no answer as to why they couldn’t tell my doctor why they were denying the refill requests. Tough shit was their attitude.

I called my doctor the next day and made an appointment so we could get me on another medication.
My disease became active on 6/12. Blood in the toilet is the big sign.

I waited until my appointment on 6/25, the earliest I could go, and my doctor put me on steroids to get the inflammation under control as well as put in an order for the new medication to keep me stable going forward. It took 2 more weeks for Blue Cross to approve the new medication all while my condition got progressively worse.

I went to the ER for the eventual pain on 7/4. They gave me pain meds and said if I don’t start the new medication soon come back. I went back to the hospital on 7/9 and they admitted me. I hadn’t eaten in days from the pain. I was torn up inside, bleeding a lot, and my case was severe. I stayed under constant monitoring and pain meds until I stabilized. I couldn’t eat solid food until this past Sunday 7/27. The doctors put me on IV steroids and I recovered slowly. The attending doctor pushed me out the door on 7/19 like I had overstayed my welcome. I didn’t feel like I was ready. He wouldn’t listen to my concerns about staying until the day before first medication infusion like the GI had preferred.

The morning of the 21st I was bleeding profusely, I became unconscious and fell from the blood loss and my wife took me back to the hospital. They admitted me, gave me a blood transfusion, stopped the bleeding with IV steroids, and another blood transfusion on the 23rd before going to get started on my new medication.

Friday morning 7/25 at 1 am I had a little blood again, at 9 am I had a toilet full of blood, fell in the bathroom, had what my wife described as a seizure, gasping for air and unresponsive for 30 seconds. She thought I was dying and called an ambulance. I went to a different hospital and received another blood transfusion and IV steroids. I was not responding to steroid pills since my large intestine was scrapped out inside. Over the last week I’ve had 3 more blood transfusions with more medication so I don’t die.

I’m still in the hospital. Might go home Sunday?

I dropped 30 pounds as my body catabolized as much muscle as it needed to replace my blood and sustain me while I couldn’t eat food.

None of this should have happened. Blue Cross knows how severe this condition can get. My doctor knows how severe this condition can get and didn’t push to get me my medication through either a peer review with Blue Cross or just starting a different medication after 2 months of denials.

Am I crazy to think someone is responsible for my suffering?

Morgan & Morgan didn’t think so…….