Local woman battles insurance provider to get money for daughter’s recommended care

CHARLOTTE — A Charlotte woman is speaking out about her fight to get her daughter, who lives with disabilities, recommended medical care that insurance refused to cover.

Marie Phillippe introduced Channel 9′s Allison Latos to her 23-year-old daughter, Chelley.

“She does bring me joy every day,” Marie said.

Chelley was diagnosed with autism when she was two. She receives in-home care through Medicaid.

After Chelley contracted COVID-19, her doctor recommended she limit her interaction with the public. But staying home led to weight gain.

“The doctor said we have to find a way to lose weight and the only way they could see how was to get a treadmill in the home,” Marie said.

Despite a letter from the doctor, Marie said Alliance Health, the managed care organization overseeing Chelley’s Medicaid, repeatedly denied coverage for the $2,000 treadmill.

“It was nothing but grief and disrespect,” Marie said. “I was not going to give up.”

Alliance Health recommended Chelley try group fitness, nutrition consultation or walking in her neighborhood.

“I laid it out,” Marie said. “Three pages. I laid out for them why those were not viable options for her.”

After three months of pushing, Marie went to state Medicaid officials who verified the policy does, in fact, cover a treadmill.

Now, Chelley can exercise at home. Marie is grateful her fight prompted greater education for the folks approving or denying claims.

“I’m so happy other families won’t have to go through what I went through,” she said.

Alliance Health wouldn’t comment on the particular case, but they told us the state has provided assistance to all managed care organizations about policy interpretations.

(WATCH BELOW: NC health bill with Medicaid expansion gets first Senate OK)

NC health bill with Medicaid expansion gets first Senate OK

©2022 Cox Media Group