Wednesday, August 24, 2011

Sound off on Insurance companies

First, I must say I am thankful to have insurance, it is true, I am. However, I do not think they realize the extent to which I loathe their practices. Nor am I naive enough to think they care what I think, but this is my sounding board so I will speak my truth and be done with it...get it off my chest because I am not a happy camper at the moment.

For those of you with serious chronic illnesses you are aware that managing your insurance/doctor's appointments/referrals/prescriptions/ a Full Time Job. A job without pay, a job that only creates stress and awe at the purposeful lack of common sense and ignorance coming from the decision makers. What never ceases to amaze me however is the fact that I know they are trying to reduce their spend but while they dilly dally over comparatively inexpensive medication approvals or appointment approvals, I end up hospitalized and another $15,000 - $25,000 is in the hole for the insurance company...all which could have been prevented mind you if they listened to my doctor in the first place.

This weeks fun all began with a change in my IVIG dose and frequency. Instead of 40 grams every 10 days my doctor wants me back on 30 grams every 7 days. given the fact that this worked well in the past and I have been in the hospital 2 times in the last 30 days it is the best that can be done to control my illness. So...last week, my home infusion company called to let me know they would send my nurse since I already have the medication and hopefully the authorization would be through by the time I needed my 2nd treatment.

I coordinated with my nurse and everything was set for 1:30pm yesterday. Now, you have to understand what is involved in prepping for a treatment. Every time I have IVIG I take benedryl and pain medicine an hour before and I use lidocaine to numb the skin covering my port. This leaves me very drowsy and I am allergic to all tape known to mankind so I also wind up a bit itchy from covering the lidocaine.

Sometimes my nurse runs late because of another patient so I patiently awaited her arrival...that is until about 2:15pm when I started nodding off. Not wanting to be rude I waited until 3pm, at this point I was ticked that she hadn't called but thought, maybe something was wrong. When she answered she was surprised that no one had called me...they decided not to do my treatment until insurance approved my change in is a lower dose so it is actually the same price as what they approved previously.

So I called my doctor, the pharmaceutical company, my infusion company, and my insurance company. By 5pm they agreed to give me my treatment so I don't end up in the hospital but now I have one week for the insurance company to come through and approve treatment or I am left hanging. I don't have the energy to call my insurance company today, I am already weak and I am worried the stress will make me sicker so...I will call tomorrow..yikes! And that is today's 2 cents.

1 comment:

  1. Trying to deal with everything is very stressfull I can't agree with you more.