On the phone again

Happy March! It’s almost spring!! Well, not here but someplace…

This insurance c**p is driving me nuts, taking too, too much time and ruining my disposition (which is normally quite cheerful).

My prior insurance experiences have not been anywhere near as exasperating.

Thirty three years ago (in June) our first child ended up in NICU at birth, in another hospital, for about a week. He weighed too much (10.5 lbs) (umm, do you think you might have diabetes???), it was a c-section and he aspirated meconium. He stayed there for about a week. When we went to check out at the business office, the clerk gently said, “Your insurance has been refused. You owe us a gajillion dollars.” After taking a deep breath and contemplating writing a really bad check, my husband checked the paperwork and found the hospital was using the wrong insurance policy (mine, not his). So that got fixed and we got to bring the baby home. (I’ve always wondered if they would have kept him ((the baby, not the husband)) if we couldn’t pay. And there are days I contemplated sending him ((yup, the baby)) back for a refund…) I spent hours on the phone (on a wall phone with a 12 foot cord and a colicky baby) in the next weeks correcting the insurance info. One of the NICU doctors sent one bill and never billed us again. Apparently, if he thought you couldn’t pay, he didn’t bill you. Yeah, the good old days… (I did call and give them the correct insurance info.)

So years went by, usual bumps, stitches, stuff, with now two boys. No real problems with our health insurance.

Son number one was in college, several states far from us when he had a medical emergency and ended up in the hospital. Every time I called the insurance company to check on appointments, tests, etc… I was told, “Sure, no problem, yes, it’s covered.”

Now it’s me. We do have insurance. It’s the main reason I continue working. It’s not fabulous but for the most part, it’s been good and we are grateful.

When approved for the pump last fall, the endo’s office explained that they require that I do the pump training through a local Diabetes Education Office. Fine. Turns out I had to repeat all the “D-Education Stuff” that I had done five years ago but that’s ok, it’s the procedure, so we did that. Then we had the pump training (several appointments) with a CDE in the office. She’s awesome. They offered great support and I felt good about pushing the magic buttons on the pump. Then… the bills started rolling in and we owed big bucks as the insurance company said I’d had more than my fair share of “D-Education” and they weren’t going to pay for it.

I called the insurance company and got NO help there. I called the Diabetes Education Office and they just bill through the hospital so couldn’t help. I called the hospital and the rep was very nice but, could only offer me a payment plan as the first payment needed to be done this week or it would go to collections. Egads! I called the HR person for the diocese (I work for a Catholic church). She declared it to be ridiculous and it WOULD be paid. I spoke with the hospital today and apparently someone in the billing office has contacted the insurance company to appeal the lack of payments. The endo’s office says I’m the first person this has happened to, to their knowledge. They wrote a letter to the insurance company.

So, I feel somewhat better about the whole issue this evening. Not wonderful, but… The HR person has been very nice. She has no clue what an insulin pump is but she’s asked questions and showed interest.

Using a pump was a big decision. We knew we’d have to pay for part of the pump, 20%. We knew I’d have more co-pays for the training appointments and we decided it was worth it.

And yup, the pump is definitely worth it. Life is simpler. I feel like I have more control over my own body (not easy at my age :).

Having diabetes or any other chronic disease should not be a further challenge due to insurance issues. I consider myself to be a responsible health consumer. I have been careful to have lab reports sent to my PCP and the Endo so not to repeat testing. I use the insurance company’s pharmacy for the most part. I try not to waste money (mine and their’s) when it comes to healthcare.

I know there are people with no insurance. I know there are d-bloggers who have had to fight for every bit of financial support from insurance companies. But it still stinks…

And that’s my gripe for this evening/this week/this month, whatever…

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3 Responses to On the phone again

  1. Crystal says:

    I was singing….on the road again. 😉

    Glad it all worked out. Insurance companies stink….I SO agree. Boo on them!

    Happy March! Spring Is somewhere, ha!

  2. Rachel says:

    Absolutely, I don't try to be a huge consumer of health care, either. So far, we've had few insurance worries (knock on wood). G isn't on a pump and one of the reasons is possible insurance hassles. There's always the chance that insurance will consider my second surgery elective (ugh).

    Even so, I feel compassion for those who deal with the insurance messes. It shouldn't be this way – it should be easy to receive and pay for health care.

  3. Karen G says:

    This is why I get so upset when people claim there is nothing wrong with the healthcare industry and that our insurance system works just fine. It may seem that way – until you really need it. Then you see just how stressful and ridiculous it all can be. I really hope everything is on the right track for you right now and that you get the coverage you need and deserve!!

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