Friday 4th of August 2017 10:46:20 PM
I am a 52 year old female, severely disabled, rheumatoid arthritic, with several other complicating diseases. I have lost the majority of my teeth, due to the various arthritis and diseases that I have. These diseases would be rheumatoid arthritis, Sjogren's syndrome, osteoporosis, osteoarthritis, chronic pain, depression, chronic kidney disease, and severely damaged bone density, among others. In an effort to improve my bone health, I have even taken the very questionable, and now proven to be devastating to my health, bisphosphonates, such as Fosamax, and Boniva. These were made available to me through my physician's offices, by the abundant free samples at the time, and through the years. Because I could not afford the cost to purchase them at the time, and due to lack of insurance upon applying for disability, I had to count on those free samples. There were no records of actual prescriptions written, and filled to back up any future claims, because I had the free samples to use. That lack of insurance would be because of the 25 month waiting period, during which time, I still paid my monthly Medicare premiums, but without any benefit to me by way of any services, especially for prescriptions.Once that 25 month period had passed, I begged AARP Humana, my insurer at that time (May 2007), and through 2009, and now for the past two years AARP Secure Horizons through United Healthcare, to remove my remaining severely damaged teeth, which were then and are still continuing to cause so many additional problems for me due to my weakened immune system. I have begged AARP Secure Horizons to rebuild my deteriorating jawbone, again as a result of all of the above mentioned maladies. I have also begged them to replace the missing teeth, once they were finally pulled, with a denture. This is in order for me to eat the proper foods, as prescribed by my physician, and supported by medical research, in order to maintain as healthy an immune system as possible.I have been repeatedly declined, despite the systemic damages, such as through my kidney, and gastrointestinal health problems, being caused from their denial, and the medical research that proves the damage, that will be done by not having these teeth removed, and the dentures put in place. Only after appealing to my local congressman, who in turn sent a letter of investigation, did AARP Secure Horizons agree to remove the teeth, and rebuild the jawbone through a two year stint of bone grafting. You see, my jawbone is now so wasted away, because of all of this delay, and the lack of any viable healthy teeth, that my face is now losing it's natural shape.AARP Secure Horizons is even required by Medicare to cover dental implants, with the actual manual labor of preparing the jaw for the implants, after the bone grafting is complete, being the only eligible covered event. They are not, however, required to provide the implants themselves. They just make the room for them. Still, Secure Horizons refuses to provide the dentures that I will need, while all of this work is being done. These dentures must be molded in my mouth, prior to removal of the teeth, therefore the insurance company is claiming that procedure to be the primary event. Instead of the removal of the teeth being the primary, and being medically necessary at that.This is how the insurer can say that the dentures are the primary reason for the medical procedure, and are therefore not covered.The dentures have been quoted by one of their own approved providers at $2,880. This must be a customized denture, due to the ongoing bone grafting taking place over the estimated two years. All of this work, will also change the shape of my jawbone's contour, and the denture must be periodically adjusted to accommodate these changes. I can't afford any of this, and that is because I am only receiving enough income to set me, just over the poverty level. In addition, any money that I do receive, goes to all of the medications that I need each month, because I don't qualify for any of the medically needy assistance, or share of cost programs, food stamps, or any other programs, normally available to the poor. I have so many other extenuating health circumstances, that I can no longer afford the medications that I need, just to stay alive, not to mention food and clothing.I currently received a net of $1,430 per month. Many people would scoff at that, and tell me to stop whining, but when they look at what I have going out, and yet still need because of all of my medical costs, they might have a different attitude. You see, I don't qualify for food stamps, or medicaid (which by the way covers dentures and dental work). I don't get assistance with anything at all, so don't think for a second that I have it made. I am slowly dying on the vine, and that huge monster conglomerate, that I actually feed each month with my medicare premiums, is letting me do just that.My point is this, if AARP would only "do the right thing" as it were, and finish the job, that they are required to start by Medicare, by providing those dentures, then I could begin to heal in so many ways. I suffer from one infection after another due to these remaining teeth, but they are all that I have, with which to eat food, despite the risks of keeping them in my mouth. My physician has literally screamed at me, to have these teeth pulled, because in his words, all it will take is one abscess, and I'm finished. Oh, please keep in mind, that I am also a depressant, and now AARP Secure Horizons has raised the cost of my generic medicines from $6 to $45, which I can not afford, so I am also writing this through many tears of utter frustration, and disbelief that I could be treated so callously by a company that only thinks of their bottom line, and not the lives of their intrusted patients.I have appealed their decision all the way up the line, and those so called mediators or unbiased parties (hired by United Healthcare no less), have always denied me without so much as a phone call to discuss, or allowing me to provide any information to support my case, before they closed my case out for good. If there is a better alternative out there, I wish that I had known about it. As it is, I am now stuck with a worthless insurance company, a mediating experience that left no doubt, as to who's pocket they were in, continued damaged teeth, infections, and no dentures, plus no anti-depressants with which to somewhat deal with this situation. I have never felt more victimized by this, than from the day that I was first diagnosed with Rheumatoid Arthritis.Please, if there is any information out there that may help, please, please let me know. Otherwise, please let your family, friends, and associates know that this can, and will happen to them.