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Insurance finally approves child's medication after Contact Denver7 steps in

Insurance finally approves child's medication after Contact Denver7 steps in
Posted at 5:45 PM, Apr 05, 2023

HIGHLANDS RANCH, Colo. — Contact Denver7 is our promise to fight for solutions. So when we heard about a Highlands Ranch mother desperate to get her daughter's medication after it was denied by insurance, we started asking questions.

"My daughter's name is Hope Held. She was born with a disorder called Smith-Lemli-Opitz syndrome," said Dana Held.

Dana thought she had learned to navigate the healthcare system after years of fighting for her daughter.

"But this last year, she was actually diagnosed with an autoimmune disorder that's quite rare. And it impacts her vision. And you know, she loves watching TV, and she loves riding horses. And her vision is very important to her," the mother said.

Dana said her daughter's doctor prescribed Humira — an injectable medication used to treat inflammatory autoimmune diseases — last year, and their insurance company, United Healthcare, approved it. This year, though, when the doctor recommended increasing the dose from every other week to every week, Dana received a letter denying coverage.

Insurance finally approves child's medication after Contact Denver7 steps in

The mother said appeals were in the works, but several weeks passed while they waited impatiently.

"Because my daughter has already lost vision in her right eye. And she was struggling with her left eye now due to this autoimmune condition," said Dana. "Three weeks went by, and we went to the doctor, and they're like, "Gosh, it's worse. When are you going to start the Humira weekly?" And I'm like, 'I don't know.'"

Contact Denver7 reached out to United Healthcare, which declined to comment due to privacy laws. But that same day, Dana said she received a call that Hope's medication had been approved.

"Thank you so much for caring. Really, that's the thing that hit me the most I think — and I'll cry — is that someone cared enough to get involved," said Dana, who received the medicine on Friday and gave Hope her first extra dose this week. "Nothing I did was working. And I finally thought maybe I should go to Channel Seven. Didn't really think you guys could help either. But lo and behold, you're miracle workers. You did."

Editor's note: Denver7 seeks out audience tips and feedback to help people in need, resolve problems and hold the powerful accountable. If you know of a community need we can address or have a story idea for our consumer team to pursue, please email us at contact7@denver7.com or call (303) 832-7777. Find more Contact Denver7 stories here. You can also use the form below to request help from Jaclyn Allen and the Contact Denver7 Team.


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