Insurance Companies, Did You Just Cringe?

Posted by Chris on Sep 3, 2009 in CGM, Insurance, Stress | 2 comments

Insurance companies. How many of you just cringed and made a sour face as soon as you read those first two words? I know I do. I don’t know what it is about that set of words. Even when I was younger I didn’t like those words, and I didn’t even know anything about them. As my uncle always called them, “in-case-stuff-happens companies” as in they are useless unless stuff happens. Insurance companies brought a whole new level of hatred into my life when I became diabetic.

I didn’t really deal with them the first 2 years of my diabetes because my mom handled just about everything. I just simply went to the pharmacy to pick up my prescriptions and went to the doctors office and handed them a card. Once I moved to Florida to finish college, that’s when I had to deal with things myself.

I can remember the first bad experience that I had with them. I had only 1 vial of insulin left and I pulled it out of the fridge to get it to room temperature about a day or 2 before I would actually use it. As I was taking it out of the nice little box it comes in, it slipped out of my hands and smashed on the floor and insulin went everywhere. Not only did I have an insulin smelling floor, (disgusting!) I was now going to be out of insulin within the next few days.

I went over to the student pharmacy the next day and pharmacist said ok it should be here tomorrow. I get a phone call the next morning to come in and see him. Guess what? Insulin is there but the insurance company isn’t covering it so it is going to cost me approximately $500 with the student discount. Reason for why they won’t cover it you may ask? Because I have a 90 day supply and we are only on day number 78. I still remember the day of my 90 day prescription I was on because it made me so pissed. After I explained to the rep that I will be dead before day 90 comes around, she transferred me to multiple people. Finally, on a one time basis, they will cover the insulin.

Now, fast forward 3 1/2 years to last week. I received a new pump and CGM from my diabetes supplier earlier in the year. They are out of network with my insurance so no big deal, that will eat up my out of network deductible. Well I keep receiving statements in the mail showing that none of my deductible has been met. This doesn’t make sense to me. Also, every month I receive a letter telling me that I haven’t sent in the additional information that was requested of me and I must send in something in writing or my claim will be denied.

Huh? What? I never received anything in the mail stating I had to send in anything! Every single time I call they tell me that I just have to submit my appeal in writing. Well, what the hell am I appealing? I haven’t received anything telling me I need to appeal! Long story short they are requesting months of blood sugar logs, CGM reports, A1C reports, etc. If they just would have told me that months ago I could have had it to them right away. Hopefully I can get this all straightened out and taken care of. I don’t need the added stress.

Just another reason I can’t stand insurance companies!

And just another day in the life of a diabetic

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2 Responses to “Insurance Companies, Did You Just Cringe?”

Minnesota Nice says:

September 3, 2009 at 9:35 PM

Mercy. For the 20 years prior to ’09, I was on a lovely HMO – no hassles whatsoever. I paid my co-pay, picked up my prescriptions at the neighborhood pharmacy, and went home a happy camper. Well, my employer dropped them and we had to go with Blue Cross and that dreadful mailorder pharmacy, Express Scripts. It took me ten weeks to get my first shipment of insulin; UPS left my thyroid meds on the sidewalk; I was mailed someone else’s antipsychotic medication, and my cholesterol pills were the wrong strength. None of the phone reps knew anything. So, I learned a little bit about persistence and patience, and being on hold for 30 minutes at a time. My employer is nationwide and has health care liasons at its headquarters. She and I did cxonference calls back and forth until I got what I needed. Major suckage. Leaves me exhausted just thinking about it.
Good luck in getting this all figured out.
Chris says:

September 5, 2009 at 2:50 PM

That is outrageous. It sounds that by the time all of this happened, maybe receiving the antipsychotic meds may have not been a bad idea. I as well am on a BCBSFL PPO plan. With my old BCBS insurance I just picked my insulin up at the pharmacy so didn’t have to deal with the mail order process, so that was usually not a bad experience except for the college mishap in the post. The testing strips was what was crazy. They would send my stuff to me without even calling to ask if I needed stuff, they would send me generic lancets instead of the ones I wanted. Luckily, now the company I get them from doesn’t do any of that, so I don’t have to worry. The first time I tried to get my insulin from this new mail order pharmacy, Prime Therapeutics was insane. I had the prescription in my hand and wanted to fax it because my doctor was going on vacation for a week. Nope, they wouldn’t take the prescription from me, had to be from my doctor. So it ended up taking a few weeks before I received my insulin, I had to pick some up at a local clinic. Hope everything is going well now.