‘Heartbreaking:’ Insurance company denies baby girl’s life-saving formula, considering it out-of-network

SACRAMENTO, Calif. — Heather Wiechert was very concerned that her daughter Mia was not growing. At 11 months old, she weighed just 14 pounds.

“A mother’s desire to feed her child runs deep,” said Wiechert.

Unable to keep food down, Mia started losing weight and ended up in the hospital. A feeding tube with a special formula is keeping Wiechert’s little girl alive.

“She desperately needs these calories to grow,” she said.

When other formulas made Mia sick, the doctor recommended a special peptide-based formula that was easier to digest, and Wiechert says, it was working. Mia started growing.

“This is it. This is it. This is what we need. This what is going to make her better,” said Wiechert.

She said her insurer considered the formula to be out-of-network, but without it, she says Mia could die.

Consumer advocate Amy Bach with United Policyholders said there is a way to get the attention of insurers.

“What happens to that kid, it’s heartbreaking. It’s very worrisome,” said Bach.

She recommends if the consequences are grave, you should present a doctor’s letter with certain buzz words. Bach says it is essential to include, “Medically necessary” and also “life-threatening.”

KOVR-TV reached out to Wiechert’s insurer, which said, “We are following up with the member and actively working to help the family access the requested formula.”

Wiechert said that after the TV station reached out to the insurer, they approved the formula for six months. She said after the extra stress, she plans to change insurance companies.

“She needs the right kind of nutrition so that she can develop appropriately,” said Wiechert.

KOVR-TV found petitions online from people upset about their insurers not covering these life-saving formulas, which could run more than $1,000 a month.