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impressive
Literotica Guru
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- Sep 11, 2003
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You are SO much nicer than I!
Okay, companies love to be praised ... so perhaps a sentence about how pleased you've been with their coverage up to this point ???
Okay, companies love to be praised ... so perhaps a sentence about how pleased you've been with their coverage up to this point ???
LadyJeanne
deluded
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- Jun 25, 2004
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"If SummaCare wants to retain customers over long periods of time,"
They do not want to retain the sick ones, just the ones who pay premiums but don't actually need any medical care.
I'd rephrase to:
If SummaCare wants to minimize its long-term care costs, it would make better financial sense for the company to invest in the long-term health of people who might well otherwise need hospitalization, surgery, special appliances, and other items and/or services which might well cost Summa more than the cost of preventive care.
They do not want to retain the sick ones, just the ones who pay premiums but don't actually need any medical care.
I'd rephrase to:
If SummaCare wants to minimize its long-term care costs, it would make better financial sense for the company to invest in the long-term health of people who might well otherwise need hospitalization, surgery, special appliances, and other items and/or services which might well cost Summa more than the cost of preventive care.
~photoguy~
your Ad goes here. $50/mo
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Are you asking them for something ? or just scolding them ??
thewantonscribe
alone and wanton
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- Sep 15, 2005
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- 1,204
You need to use stronger language to get noticed. Also send copies of the letters to the legal department, and their publicity department.
My letter to my insurance company:
SummaCare, Inc.
Attn: Marty Hauser
444 N. Main Street
Akron, OH 44308
Re: Standard Conversion Plan Health Insurance
Group#
Division#
Dear Mr. Hauser:
On November 29th, I received a letter informing me that SummaCare was restricting coverage of self-injectable medications to an annual maximum of $1,000.00. As someone who has had Summa health insurance since before I was diagnosed with multiple sclerosis, I am appalled by the combination of short-sightedness and lack of customer care in this decision.
Consistent use of self-injectable medications for chronic illnesses such as multiple sclerosis or diabtes prevents more expensive treatments such as hospitalization, surgery, special appliances, and other items and/or services. Coverage without limitations for injectable drugs such as insulin and copaxone makes a more sensible alternative. By restricting the coverage to such a low amount it would seem that SummaCare no longer wants to provide coverage for those with chronic illnesses.
While I understand and applaud your company’s desire to avoid raising monthly rates, it should be possible for a company which recently won an award from J.D. Power & Associates to offer a compromise. Perhaps a start would be communicating with the insured to find out their needs prior to such a catamyclismic descision. A more cost effective and sensible solution might be a supplemental pharmacy rider which would cover self-injectable medications could possibly be made available to customers willing to pay an additional premium might be made available at the customer’s choice.
Thanking you in advance for your cooperation in this matter.
With Regards,[/QUOTE]
My letter to my insurance company:
SummaCare, Inc.
Attn: Marty Hauser
444 N. Main Street
Akron, OH 44308
Re: Standard Conversion Plan Health Insurance
Group#
Division#
Dear Mr. Hauser:
On November 29th, I received a letter informing me that SummaCare was restricting coverage of self-injectable medications to an annual maximum of $1,000.00. As someone who has had Summa health insurance since before I was diagnosed with multiple sclerosis, I am appalled by the combination of short-sightedness and lack of customer care in this decision.
Consistent use of self-injectable medications for chronic illnesses such as multiple sclerosis or diabtes prevents more expensive treatments such as hospitalization, surgery, special appliances, and other items and/or services. Coverage without limitations for injectable drugs such as insulin and copaxone makes a more sensible alternative. By restricting the coverage to such a low amount it would seem that SummaCare no longer wants to provide coverage for those with chronic illnesses.
While I understand and applaud your company’s desire to avoid raising monthly rates, it should be possible for a company which recently won an award from J.D. Power & Associates to offer a compromise. Perhaps a start would be communicating with the insured to find out their needs prior to such a catamyclismic descision. A more cost effective and sensible solution might be a supplemental pharmacy rider which would cover self-injectable medications could possibly be made available to customers willing to pay an additional premium might be made available at the customer’s choice.
Thanking you in advance for your cooperation in this matter.
With Regards,[/QUOTE]
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thewantonscribe
alone and wanton
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- Sep 15, 2005
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Are they offering no such changes or alternatives for those with diabetes or MS? Is that what I am understanding from your letter?
thewantonscribe
alone and wanton
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Their website shows three tiers of drugs covered. At the bottom is this message:
*SELF ADMINISTERED INJECTIBLE DRUGS
Coverage for the self-administered injectibles indicated with an asterisk (*) varies. Your prescription benefit may not cover these items. Please check your pharmacy benefit information
It may also be that a generic must be used. Often if there is no generic available with some policies a pre-authorization is required. Have you also looked into whether that may be the case?
*SELF ADMINISTERED INJECTIBLE DRUGS
Coverage for the self-administered injectibles indicated with an asterisk (*) varies. Your prescription benefit may not cover these items. Please check your pharmacy benefit information
It may also be that a generic must be used. Often if there is no generic available with some policies a pre-authorization is required. Have you also looked into whether that may be the case?
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gauchecritic
When there are grey skies
- Joined
- Jul 25, 2002
- Posts
- 7,076
I realise they'll have something in their terms and conditions that says they can alter their coverage whenever they want but I think it might be worthwhile including something about honouring custom and practice.
Also the language is neither threatening nor weadling, you should be one or the other, preferably the former including words like outrage, disgust and apalled.
On the other hand, if they can summarily discontinue your cover I suppose a more concilatory tone would be better.
Also the language is neither threatening nor weadling, you should be one or the other, preferably the former including words like outrage, disgust and apalled.
On the other hand, if they can summarily discontinue your cover I suppose a more concilatory tone would be better.
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gauchecritic
When there are grey skies
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- Jul 25, 2002
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- 7,076
re-written but a bit 'Letter to the Times'
SummaCare, Inc.
Attn: Marty Hauser
444 N. Main Street
Akron, OH 44308
Re: Standard Conversion Plan Health Insurance
Group#
Division#
Without prejudice.
Dear Mr. Hauser:
With reference to your communication of the 29th, informing me that SummaCare would be restricting coverage of self-injectable medications to an annual maximum of $1,000.00. I feel duty bound, as someone who has been covered by Summa health insurance since before I was diagnosed with multiple sclerosis, to convey in the strongest possible terms, my shock and dismay at the short-sightedness and appalling reduction of customer care apparent in this adopted policy.
Consistent use of self-injectable medications such as insulin for diabetics and copaxone for people with multiple sclerosis can alleviate potentially serious long-term side effects.
Corporate thinking which reduces outlay in the short term at the expense of eroding good will and confidence amongst its loyal clientelle can only be damaging to its own high profile and regard in the long term.
If Summacare wishes to retain the financial input of customers over long periods of time, it would make better fiscal sense for the company to invest in the long-term health of people who might well otherwise need hospitalization, surgery, special appliances, and other items and/or services which might well cost Summa more than the cost of preventive care.
While I understand and applaud your company’s desire to avoid raising monthly rates, it should be possible for a company which recently won an award from J.D. Power & Associates to offer a compromise. Just as one example, a supplemental pharmacy rider which would cover self-injectable medications could possibly be made available to customers willing to pay an additional premium might be made available at the customer’s choice.
Thank you for your anticipated attention to this letter.
Very truly yours
This is how I would have written it. Note the "Without prejudice" at the beginning which implies that there might be later court action. Start hard, go soft, offer compromise.
The paragraph about long term customers is a very weak arguement though. They don't care about long term, nor about prevention. There are millions of you paying and the short term loss of individuals is negligable.
SummaCare, Inc.
Attn: Marty Hauser
444 N. Main Street
Akron, OH 44308
Re: Standard Conversion Plan Health Insurance
Group#
Division#
Without prejudice.
Dear Mr. Hauser:
With reference to your communication of the 29th, informing me that SummaCare would be restricting coverage of self-injectable medications to an annual maximum of $1,000.00. I feel duty bound, as someone who has been covered by Summa health insurance since before I was diagnosed with multiple sclerosis, to convey in the strongest possible terms, my shock and dismay at the short-sightedness and appalling reduction of customer care apparent in this adopted policy.
Consistent use of self-injectable medications such as insulin for diabetics and copaxone for people with multiple sclerosis can alleviate potentially serious long-term side effects.
Corporate thinking which reduces outlay in the short term at the expense of eroding good will and confidence amongst its loyal clientelle can only be damaging to its own high profile and regard in the long term.
If Summacare wishes to retain the financial input of customers over long periods of time, it would make better fiscal sense for the company to invest in the long-term health of people who might well otherwise need hospitalization, surgery, special appliances, and other items and/or services which might well cost Summa more than the cost of preventive care.
While I understand and applaud your company’s desire to avoid raising monthly rates, it should be possible for a company which recently won an award from J.D. Power & Associates to offer a compromise. Just as one example, a supplemental pharmacy rider which would cover self-injectable medications could possibly be made available to customers willing to pay an additional premium might be made available at the customer’s choice.
Thank you for your anticipated attention to this letter.
Very truly yours
This is how I would have written it. Note the "Without prejudice" at the beginning which implies that there might be later court action. Start hard, go soft, offer compromise.
The paragraph about long term customers is a very weak arguement though. They don't care about long term, nor about prevention. There are millions of you paying and the short term loss of individuals is negligable.
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BlackShanglan
Silver-Tongued Papist
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- Jul 7, 2004
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- 16,888
Huzzah! Jammies is triumphant over the evil corporate weasel-beasty!
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rgraham666
Literotica Guru
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- Feb 19, 2004
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Yay Jammies! *HUGS* and 
es sweetie.
es sweetie.
impressive
Literotica Guru
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- Posts
- 27,372
lilredjammies said:
But I especially liked the "Dear Ms. Jammies" part!
BlackShanglan
Silver-Tongued Papist
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- Jul 7, 2004
- Posts
- 16,888
impressive said:
But I especially liked the "Dear Ms. Jammies" part!
How could one write a letter denying coverage to "Dear Ms. Jammies"?
It's a master stroke on her part.
Tom Collins
Ho Ho Hic
- Joined
- Nov 27, 2005
- Posts
- 9,133
I SOOOO agree.BlackShanglan said:
I'd give Ms. Jammies anything she wanted. (I'm a soft touch) Coronas with lime all round. Sorry, but you'll have to spring for the salt. If u like salt, which I do.
Ignore any typos/spelling errors you might see...I've been celibrating, cuz this means we get to keep the sweet jammie girl round. I cn edit my posts on;y so much, people. I am reduced to hunting/pecking...not good. *mumblin' to self* Why do the keys have to be so close together??
hugo_sam
Visiting
- Joined
- Apr 20, 2004
- Posts
- 11,712
lilredjammies said:Dear Ms. Jammies:
, your situation is especially difficult. Realizing this, we will extend your coverage until December 31, 2006.
The squeaky wheel got a year's worth of grease!
Yeah !!!! Jammies
That is good news. May it improve even more soon. Great news, pleasing.
Good Luck!!!!!
*Grizzly Bear Hugs*
Hugo
thewantonscribe
alone and wanton
- Joined
- Sep 15, 2005
- Posts
- 1,204
Liar said:Ah, the power of a few well chosen words. Congrats, Ms. Jammies.
Hoo rah! Good on Ya'! Very good! However you put it -- I am happy that making some noise got you the coverage you needed and deserve! Its nice to know that things worked out for the best. Thanks so much for updating on here. I have been thinking about since I posted.
Merry Christmas and Happy Holidays!
