Zaragoza Rábago I.
Devoted Acknowledged Their Failures that Persist
Devoted has demonstrated a profound failure in care coordination that has resulted in an interruption of my medically necessary HIV treatment. I am not a newly diagnosed patient. I have an established history of HIV care, recent laboratory results showing a CD4 count above 1,000, and insurance that covers Biktarvy. My HIV treatment should never have been interrupted because of administrative failures. Devoted is both my Medicare Advantage insurer and my primary care provider. This behavior confirms to me that there is little to no difference between devoted and other carriers. Insurance has always prioritized profit over people. That means coordinating medically necessary care is not simply good customer service—it is one of the fundamental responsibilities it accepted when it became both my health plan and my medical group. I am also homebound because of disability. Devoted has known this throughout the process. Despite that, I was repeatedly assured that my care would be coordinated. Those assurances proved to be false. One of Devoted's own physicians later acknowledged that the organization repeatedly set expectations it could not meet. Think about what that means. A physician representing the organization acknowledged that the failures were not isolated mistakes but repeated failures. The breakdown did not end there. My HIV viral load was never completed because Devoted's contracted laboratory failed multiple times to obtain an acceptable specimen. Devoted's own correspondence acknowledges those failures. Rather than immediately coordinating an alternative laboratory capable of performing the test, the burden was effectively shifted onto me—a homebound patient. The most astonishing part of this experience is that I have repeatedly been expected to coordinate my own specialty care by calling infectious disease offices myself. If that is the expectation, then what exactly is Devoted coordinating? What am I paying for and how would CMMS review this? What is the purpose of having an insurance company that also serves as your healthcare provider if, when medically necessary specialty care is needed, the disabled patient is expected to navigate the system alone? Because I am homebound, I requested a reasonable accommodation under the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act. I am not asking for special treatment. I am asking for meaningful and equal access to medically necessary healthcare. Weeks later, I remain without the medication that should have been continued without interruption. This experience raises serious questions about how Devoted fulfills its obligations to disabled members who cannot simply get in a car and attend appointments. If this is how a patient with an established diagnosis, documented medical history, covered medication, and repeated requests for assistance is treated, I can only imagine the barriers faced by others in even more vulnerable circumstances. Healthcare should not require disabled patients to become their own case managers, referral coordinators, and patient advocates simply to obtain covered, medically necessary treatment. I hope Devoted treats this review as an opportunity for serious self-examination. Patients deserve more than apologies, promises, and explanations after the fact. They deserve competent care coordination, meaningful disability accommodations, and uninterrupted access to medically necessary treatment. My experience has reflected none of those things.