Wednesday, January 9, 2013

Insurance Hell

I don't believe in hell, but if I did I think it would be similar to fighting with insurance companies for eternity. Fighting with insurance companies isn't a new thing for me, I remember countless times being at work on my 15 minute break or my 30 minute lunch break sitting on hold only to hang up before anyone could help me because my break was over. I would get so aggravated that I used up my only opportunity to run to the restroom or eat dealing with what was often the insurance companies mistakes. I hated dealing with them then, but dealing with insurance companies while caring for a baby is a whole new ballgame!

I need not even explain the details to my fellow cysters and fibros, you already know. You too have been there countless times. I will mention that despite having this insurance for about 8 years they claimed at one point during my conversation with them that I never did in fact have insurance through them. Quite generous to pay the medical bills of a patient for 8 years that never had insurance, don't you think? Sigh.

The part that makes me the most angry is that for three days I started making calls when Kaylee went down for her first nap (at 8am) and was on the phone for her entire nap and continued to be on the phone all through her play time and finally through her second nap. I am now quite talented at changing diapers, doing laundry, and eating all while fighting for medication I need to survive. I also learned to entertain a baby with goofy faces, dancing wildly to the music playing while on hold, rolling balls, and dangling toys, once again, while talking to insurance reps. While being distracted on the phone little Kaylee ended up bumping her head on the coffee table. She wasn't hurt badly and although she cried hard it wasn't for long. I am pretty sure this is what put me over the edge. Dealing with incompetent people at the expense of your child is enough to piss the most mellow person off. So the last thing I learned was that screaming into a pillow helps relieve some anger and that my baby thought it was I did it a few more times for good measure.


  1. Hi IH!!! I'm sorry that you have to deal with the insurance company. I guess I REALLY should count myself as lucky bc I have never ever (knocking on wood) had to argue about meds. I have been on the same insurance with the same company since I have graduated college which is over 5 years now.

    So I guess this is happening to others as well. I am saddened to read this bc it shouldn't have to be this way. I hope you get everything resolved soon cyster :)

    If you care to mention what are they giving you grief over?

  2. Wow, I am impressed that you never had to fight with your insurance company. I am a little jealous!

    The BIGGEST issue is that my insurance ONLY has a message machine meaning you have to leave a message and wait for them to call you back. There is no way to speak to a person when you call so you are at the mercy of when/if they call you.

    Basically, my insurance company "forgot" to give me a new authorization number for 2013 so my pharmacy couldn't get them to cover my meds. When I called the insurance claimed I was never insured by them (???) and that I needed to send proof that I had insurance through them. Later, they called to say they found my paperwork, but I needed to fill out an updated form before doing anything. I faxed the paperwork in yesterday, but I am still waiting.

    I paid out of pocket for meds I could afford and the pharmacy sent me a small supply of enzymes ($1,000 worth - eek) that I will be financially responsible for if my insurance issue isn't worked out, but I am sure it will work out it is just a question of when..

  3. Oh gosh, IH I really feel your pain on this one. One thing I've learned that helps is to get the direct number of someone high up that you can call each time that you run into trouble. I also start writing down everyone's name of who I talk to even if I get transfered- basically I jot down everything about the whole phone call. Date, time, names of people I was talking to, what department they worked for, etc etc.

    I hope things work themselves out quickly.

    Have you talked to your CF social worker to see if she/he could help out? I know my social worker is AWESOME when it comes to dealing with incompetent insurance agencies.

    1. Ugh, my social worker is useless, but my nurse practitioner is really helpful and she did help me a lot during this crazy ordeal. I am not sure how the clinic would function without her- she is amazing!

      I need to start writing down names because it seemed like everybody was on a different page and I got so much conflicting advice!

  4. Man I so feel for all of you who live in the US. Luckily in Canada and the UK we don't have private health care so everyone has the same coverage from the government. In Canada we have a scale based on income for paying for meds and you have an amount every year you have to pay and once you've reached that it's all paid for. Our excellent CF team are constantly working for all of the CF drugs to be covered for us. The only problem is it resets in January so it ends up being an expensive month. Of course the nebs for one month will cost the full amount of my deductable for the year and then everything else is paid for. January is always an expensive month!!

    1. How nice! January is always a pain for me because with the new year they need new applications and I feel like something ALWAYS happens which delays me getting my meds. It really is ridiculous! I would rather have an expensive January than one without meds!