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Every day, a Massachusetts mom named Lauri takes her 26-year-old daughter named Ashley, who has intellectual disabilities and several complex medical needs, to doctor’s visits, keeps her on a medication schedule, gets her Dunkin Donuts coffee at 2 p.m. and attends to her needs, a well-oiled machine of love and caretaking.
But that machine was in danger of breaking down in December when a pharmacy called Lauri to tell her that coverage for one of her daughter’s medications had been denied.
That medication is usually covered by Ashley’s health plan.
“Ashley faces multiple challenges, and health insurance is really important,” Lauri said. “It would be a whole new world if her Blue Cross coverage dropped.”
So Lauri picked up the phone, called the Blue Cross Blue Shield of Massachusetts member services team late on a Friday evening and was connected to Staci Deane (pictured above). As Lauri calmly explained that an important medication for her disabled daughter had been denied, she braced herself for a difficult conversation but, she said, Deane surprised her.
“Staci said, ‘No problem, we’ve got your back,’ and I burst into tears,” Lauri said. “When was the last time an insurance company called you and said, ‘We’ve got your back?’ Staci heard in me that I’m managing 100 things. I thought it was unbelievable that she had so much compassion,” especially since Lauri hadn’t even explained the full spectrum of her daughter’s needs.
After telling Lauri she would look into her issue and call her back, Deane immediately began collaborating with a team of people from the company to resolve Lauri’s issue after-hours. Deane worked with the team to correct an error in Ashley’s enrollment and then called the pharmacy to allow Lauri to get a few days’ worth of her daughter’s medication that evening so she would have enough until her updated enrollment status took effect first thing Monday morning.
When Deane called Lauri back to update her, Lauri was overcome with gratitude.
“I’ve had to advocate all of Ashley’s life—for her to be included, for her not to be bullied, for us to stay overnight when she was in the PICU. There hasn’t been a day that I have not advocated for her. But that day, Staci took care of me. She was determined not to let the day end without easing my mind.”
Little did Lauri know how well Deane understood her situation.
“I told Lauri that I had worked at a group home for people with disabilities,” Deane said, but she hadn’t told Lauri that she had spent 15 years there before making the switch to Blue Cross less than a year ago. She also didn’t tell her that seven years ago, she had invited a young woman who is quadriplegic to come and live with her and her family and that the young woman has lived with them ever since.
“I’ve been in those shoes,” Deane said. “I know firsthand about having to advocate for somebody else, and I know how demanding that role can be—physically, emotionally, mentally. It’s really nice to know that I could take that burden from Lauri for a little while.”
“I know my daughter is important to me, but I felt like she was important to her, too,” Lauri said. “I am unbelievably grateful. Staci had no idea what she did for my heart that day.”