Piling On
July 19th, 2006
It just never ends with the goddamn health insurance. Which, as previously established here at EGW, tends to make me EVEN MORE SICK.
I pulled my head out from under the pillow this morning - after dropping it there is a fit of frustrated tears inspired by dear Pacificare - long enough to read Dooce. And she’s apparently having her own issues with the rat bastards who are running health care in this country like a totalitarian regime. Which inspired me to air my own grievances…again.
In this particular case, I am trying, hoping, crossing my fingers, praying, pleading, cajoling and harassing in order to get my insurance provider to approve an expensive medication I really, really need (I’d add “threaten” to the list, but they are unafraid). I’m pretty sure they’re going to approve it, but it is clearly in the Pacificare manual and mission statement that they must TORTURE ME first. With a maze of beaurocracy and circular logic and an immensely long wait time.
I can’t possibly hear the words approve, authorize or verify ever, ever again.
Are they hoping I’ll just give up? Is the plan to make me die of sheer frustration and utter hopelessness before I get to fill the prescription? One thing is clear: they are definitely not in the business of caring for my health.
If there is an upside, it’s been the erosion of my fear of taking this drug. You see, I have to self-inject it into my thigh once a week. I am weak-kneed and fussy when it comes to things like this, and I had been dreading the moment when I came face-to-face with that needle for the first time. But now? Now that I’ve been BEGGING for it for months, feeling physically even worse (thanks to the wait), and filled with vengenance towards Pacificare - now I can’t wait to stick myself with that needle. HA! THAT WILL SHOW THEM!
Oh my god. Do you see what they’ve done to me?
Ok, kiddo…I’m going to be watching, and if 7/1 comes around and you’re denied this stuff, I’m going to want to read about how you set a fire under the bureaucrats by going to the State of Ca advocates!
I heard an amazing story today from one of our nurses, about her elderly cancer-afflicted mother who could not access her chemotherapy because of the HOOPS posed by my illustrious (#1 rated) HMO. I can guarrantee you that the folks who designed the process for getting this med had no idea of the mess they were creating for this poor woman.
I know this feels very personal, but don’t assume a victim role! Fact is, if you go on the offense, you’re apt to do much better with them. You would be absolutely amazed what calling in the cops can accomplish.
You are smart, strong and entitled to this med!
Love you, love the blog!
Marilyn-O
You wrote about them just hoping you will give up- I have been coming more and more to the conclusion that that is the #1 strategy of the health care industry. My story is not as horrible as yours- but it is still very very frustrating.
I have been arguing about a $160 bill from an appointment my daughter had last November since last December. After spending hours and hours with both Children’s hospital and my insurance I have been told countless times that we are not responsible for the bill- only to be sent a new bill a month later. Last week we got a call and a bill from a COLLECTION agency threating our credit rating. If $160 wasn’t a shitload of money for us right now I probably would pay it just to have it be over with.
The thing is that this happens at least once probably twice a year. Amazingly all of the mistakes they make favor the insurance agency. (Kind of like how all of the mistakes during the 2004 vote count in Ohio favored Bush) It is a total racket.
OMG, the same thing happened to me when I was pregnant. I vomited to the point of severe dehydration that required regular visits to the ER for “re-hydration therapy.”
The one thing that stopped the madness — that took my vomiting from life threatening to just awful and uncomfortable — was Zofran, medication given to cancer patients and pregnant women.
My doctor, who cares more about my health than pinching pennies, prescribed several weeks worth at a time. But the dreaded Pacificare would only allow the pharmacy to fill 3 days worth. Anyone who has ever had a prescription filled knows how hard it is to get your medication in a timely manner. So, in my dehydrated state, I was constantly on the phone to the pharmacy calling in my meds, begging them to please fill it before my current round ran out.
And my dear, sweet husband, my mother, or anyone else who was willing to battle the pharmacy on my behalf, was constantly rushing to the pharmacy to pick up my 6 pills. When I did run out, chaos ensued, and I usually ended up in the emergency room all over again.
You’d think that Pacificare would recognize that the cost of an ER visit is more expensive than letting me get extra pills (THAT I WOULD USE ANYWAY!!!). I was just too sick and exhausted to fight them, so we did the medication dance for nearly 5 months, before my pregnancy mercifully ended.
Wow, this is pretty long. Just shows how strongly I feel about this nearly 7 months later. Go Jess!!! I’m glad you are fighting to get what you need.