F'ing Insurance

Our pediatrician and CF doctors recommended that Drew get a special vaccine called Synagis which protects against RSV. RSV is respiratory syncytial virus and its a particularly nasty virus in kids with chronic lung problems. Older, healthy kids who might catch this bug would probably just end up with an ugly cold, but in high risk kids, particularly babies, in can have serious and even deadly effects. Its apparently very hard to get this vaccine unless you have a qualifying condition. Here are some of the American Association of Pediatrics recommendations for who should get this vaccine:

1) Infants and children under age 2 years who have required treatment for chronic lung disease, such as oxygen, bronchodilators, diuretics, or steroids, within 6 months of the start of RSV season.

Our doctors sent in all of the paperwork to our insurance company so that he could get this shot once a month from November - April (the "season" for RSV) and I just got a call that he was declined. DECLINED!! The woman from Anthem that called said that the doctor had reviewed the case and Cystic Fibrosis is not a qualifying illness and it is not necessary for him to receive this vaccine. Seriously? A real life doctor, someone with an actual medical degree declined this? If they won't consider Drew high-risk, who will they? I know why they declined him. Its $1000 a shot and he needs 6 shots. We pay a damn fortune toward insurance every month toward our premium and even more toward hospital bills and prescriptions, and they won't pay for him to get this critical vaccine because he doesn't qualify?! BS. I'm appealing it. I asked her how the process work. I've made the phone calls. All in the past 20 minutes since they called me to say they were declining us. And at the end of the call she asked if I had any other questions. I said no. She said well I hope you have a nice Halloween! Fuck you.