In 2006 my husband was diagnosed with Kidney Failure that was a life changing event for both of us, though I didn't go through the physical part everyday I go through the emotional. Everyday I wake up and thank God for giving me another day with the love of my life and for watching over him as he continues to stay healthy and strong. Everyday I have a fear that that could all change but quickly move on because I have faith that we will continue to be blessed but I will always be extremely protective of my husband and emotional when it comes to his health because of what we have gone through. I am sure this is how everyone who has a loved one who has suffered or does suffer from a life changing illness feels. People who have not gone through this experience should feel lucky that they do not understand this feeling.
With that being said I also have anger, lots of anger because of the Health "Care" business, and this is what I deal with on a constant basis. I am not a political person, I am an emotional and open minded person so this is just me venting from the stress Insurance companies have caused me over the past 10 years. From the beginning I have dealt with countless nurses, doctors, hospitals, and pharmacies sadly not all of them are in the business because they CARE. But the worst people that I deal with are the insurance companies. I can count on 1 hand the number of helpful people during this entire journey, that makes me sad, anger, and disgusted.
Edgar doesn't take "normal" medications that you can easily get at your local pharmacy he takes specially medications which include 2 anti-rejection medications, he has taken the same drugs since his transplant in 2007 so we have to get his prescriptions filled through our insurance home delivery service (local pharmacies do not usually carry these drugs on hand) . A few months ago the insurance company we had at the time (we had the same one for the previous 2 years) decided they would no longer approve his anti-rejection medications, WTH. This came from left field , we were not notified until it was time to call in a refill and we could not get a straight answer as to why this was the case even Edgar's Doctor didn't understand this and spent over an hour on the phone talking to the company explaining why it was important Edgar continue on the same drug he had been on for the last 10 years. However the insurance didn't "care" . They are not Doctors they are just business people trying to make money and they think they know what is best for my husband, how is this allowed? Don't they understand that if my husband changes his medication he runs a higher chance of rejecting his kidney which would cause him to need dialysis and another transplant which equals more money from the insurance company?
I deal with crap like this every time we have had to change insurance companies whether for a job change or because the job changes the company themselves. Anytime there is a change its such a huge process and usually takes 3- 6 months just to get Edgar's medications approved and ordered (he has been on the same 6 medications since 2007). It always involves me spending hours on the phone and always has me in tears. Thank God we FINALLY have an amazing nurse who helps me along this process because if it weren't for her the process would be even longer. The problem isn't that we can't pay for our co-pays , we aren't on any type of assistance so I truly do not understand why it is so difficult each and every time.
Just recently my husband changed jobs so I knew this meant going through the whole crazy process with the insurance company, our amazing nurse was prepared to go on this journey with me as well. On March 29th the Doctor sent all 6 prescriptions to the insurance company (after I had called to make sure they covered all the drugs, which I was told they did ,I had also asked if we would have to go through the specialty pharmacy and was told by 3 different people we did not). Two days later I called to make sure there were no issues with the prescriptions I also got our co-pays (no issues according to who I spoke to and I left a cc on file for payment). Then on April 4th I called again because Edgar had only received 2 of the 6 Rx's and according to the website the others were still in pending status (again I was told there is no issue, I was given a different co-pay quote and even was provided with a tracking number for what I was told all the remaining medications). Edgar received a package a couple of days later but still was missing two medications 1 being an anti-rejection and the other being another drug he takes to control his water intake. I called again today to see what the issue was the first representative I spoke to was not compassionate at all (but usually they aren't) she told me that the insurance is no longer covering my husband's anti-rejection medication but she could give me alternative drugs they will approve (not this again) like I mention I am an emotional person so I start crying and go off on the girl and all she tells me is she can give me a number to call because as of the 4th my insurance changed how they would cover our prescriptions (they didn't inform us ), for the other drug she said that we have a high deductible and gave me a different number to call about that one. I proceed to call the number for the anti-rejection medication turns out all it was was that we need to order this drug through the specialty pharmacy (why wasn't I told this from the beginning when I asked) so that got taken care of. Next I called the 2nd number I was provided, the 1st person told me I was calling the wrong department and transferred me, the 2nd person told me that my husband's member ID didn't exist and he didn't have insurance through them (I was giving the correct number) she was extremely rude and told me I must have Medicare (I know what we have and we DO NOT have that). I hung up and called the number on the back of my insurance card again, I got a nice lady but yelled at her right away asking for a supervisor she asked me to give her an opportunity to help I had already spent several hours on the phone so I said fine give it a shot. Turns out the account was full of notes that explained why the prescriptions hadn't been mailed out yet. She was extremely empathetic and told me exactly what I need to do and even put a rush on the medication at no extra cost to us. So my question is WHY DOES IT HAVE TO BE SO HARD ALL THE TIME. Why out of ALL the people I have spoken to over the past few weeks has one 1 person taken the time to do their job so that we can get this taken care of? This could have been resolved weeks ago! And why do insurance companies make it SO hard to get medication that are needed to live a healthy long life? What can I do to make this better? I want to change this. We have private insurance that we pay a premium for, we pay our co pays, we pay our taxes how are people who don't have the means to pay for their prescriptions treated? What about elderly people? What if someone doesn't have another person looking out for them? Are we suppose to just go with the flow? This just seems so wrong to me. I think that the word "CARE" shouldn't be associated with people's health because there aren't too many people who actually CARE. To most it is just a business, a way to make money but it's dealing with people's lives. I couldn't get into this field because I would be disgusted by the "politics" and "business" I would have to deal with , is that what has happened to others?
When someone faces a life threatening illness that changes their life forever they are already worried about living they shouldn't have to worry about the fact a company is denying them a drug that will keep them alive because the company only is in the business of making money. This needs to change! But if it doesn't I am sure as hell going to continue to fight for my husband.
With that being said I also have anger, lots of anger because of the Health "Care" business, and this is what I deal with on a constant basis. I am not a political person, I am an emotional and open minded person so this is just me venting from the stress Insurance companies have caused me over the past 10 years. From the beginning I have dealt with countless nurses, doctors, hospitals, and pharmacies sadly not all of them are in the business because they CARE. But the worst people that I deal with are the insurance companies. I can count on 1 hand the number of helpful people during this entire journey, that makes me sad, anger, and disgusted.
Edgar doesn't take "normal" medications that you can easily get at your local pharmacy he takes specially medications which include 2 anti-rejection medications, he has taken the same drugs since his transplant in 2007 so we have to get his prescriptions filled through our insurance home delivery service (local pharmacies do not usually carry these drugs on hand) . A few months ago the insurance company we had at the time (we had the same one for the previous 2 years) decided they would no longer approve his anti-rejection medications, WTH. This came from left field , we were not notified until it was time to call in a refill and we could not get a straight answer as to why this was the case even Edgar's Doctor didn't understand this and spent over an hour on the phone talking to the company explaining why it was important Edgar continue on the same drug he had been on for the last 10 years. However the insurance didn't "care" . They are not Doctors they are just business people trying to make money and they think they know what is best for my husband, how is this allowed? Don't they understand that if my husband changes his medication he runs a higher chance of rejecting his kidney which would cause him to need dialysis and another transplant which equals more money from the insurance company?
I deal with crap like this every time we have had to change insurance companies whether for a job change or because the job changes the company themselves. Anytime there is a change its such a huge process and usually takes 3- 6 months just to get Edgar's medications approved and ordered (he has been on the same 6 medications since 2007). It always involves me spending hours on the phone and always has me in tears. Thank God we FINALLY have an amazing nurse who helps me along this process because if it weren't for her the process would be even longer. The problem isn't that we can't pay for our co-pays , we aren't on any type of assistance so I truly do not understand why it is so difficult each and every time.
Just recently my husband changed jobs so I knew this meant going through the whole crazy process with the insurance company, our amazing nurse was prepared to go on this journey with me as well. On March 29th the Doctor sent all 6 prescriptions to the insurance company (after I had called to make sure they covered all the drugs, which I was told they did ,I had also asked if we would have to go through the specialty pharmacy and was told by 3 different people we did not). Two days later I called to make sure there were no issues with the prescriptions I also got our co-pays (no issues according to who I spoke to and I left a cc on file for payment). Then on April 4th I called again because Edgar had only received 2 of the 6 Rx's and according to the website the others were still in pending status (again I was told there is no issue, I was given a different co-pay quote and even was provided with a tracking number for what I was told all the remaining medications). Edgar received a package a couple of days later but still was missing two medications 1 being an anti-rejection and the other being another drug he takes to control his water intake. I called again today to see what the issue was the first representative I spoke to was not compassionate at all (but usually they aren't) she told me that the insurance is no longer covering my husband's anti-rejection medication but she could give me alternative drugs they will approve (not this again) like I mention I am an emotional person so I start crying and go off on the girl and all she tells me is she can give me a number to call because as of the 4th my insurance changed how they would cover our prescriptions (they didn't inform us ), for the other drug she said that we have a high deductible and gave me a different number to call about that one. I proceed to call the number for the anti-rejection medication turns out all it was was that we need to order this drug through the specialty pharmacy (why wasn't I told this from the beginning when I asked) so that got taken care of. Next I called the 2nd number I was provided, the 1st person told me I was calling the wrong department and transferred me, the 2nd person told me that my husband's member ID didn't exist and he didn't have insurance through them (I was giving the correct number) she was extremely rude and told me I must have Medicare (I know what we have and we DO NOT have that). I hung up and called the number on the back of my insurance card again, I got a nice lady but yelled at her right away asking for a supervisor she asked me to give her an opportunity to help I had already spent several hours on the phone so I said fine give it a shot. Turns out the account was full of notes that explained why the prescriptions hadn't been mailed out yet. She was extremely empathetic and told me exactly what I need to do and even put a rush on the medication at no extra cost to us. So my question is WHY DOES IT HAVE TO BE SO HARD ALL THE TIME. Why out of ALL the people I have spoken to over the past few weeks has one 1 person taken the time to do their job so that we can get this taken care of? This could have been resolved weeks ago! And why do insurance companies make it SO hard to get medication that are needed to live a healthy long life? What can I do to make this better? I want to change this. We have private insurance that we pay a premium for, we pay our co pays, we pay our taxes how are people who don't have the means to pay for their prescriptions treated? What about elderly people? What if someone doesn't have another person looking out for them? Are we suppose to just go with the flow? This just seems so wrong to me. I think that the word "CARE" shouldn't be associated with people's health because there aren't too many people who actually CARE. To most it is just a business, a way to make money but it's dealing with people's lives. I couldn't get into this field because I would be disgusted by the "politics" and "business" I would have to deal with , is that what has happened to others?
When someone faces a life threatening illness that changes their life forever they are already worried about living they shouldn't have to worry about the fact a company is denying them a drug that will keep them alive because the company only is in the business of making money. This needs to change! But if it doesn't I am sure as hell going to continue to fight for my husband.
I had no idea Jen!!! Insurance companies do suck! I am having certain compilations after my surgery and some of my services just aren't covered... Like not at all. :( I can't get approved for scans and most medications are barely covered. It's just awful. It's really up to insurance companies to give us a better chance at life, not add to the stress. For the amount that is paid we should all be getting better care! It's just not fair sometimes
ReplyDeleteIt is so much work to try to call around, just to be told one thing and then have something else happen entirely. Hugs to you and your family, keep fighting!
Tracy, I am so sorry you are having to deal with issues too. My heart breaks to hear this! I just don't understand it, this is not the way it should be. You have so many other things to worry about. Please let me know if there is anything I can do to help you. I do send you tons of prayers, you keep fighting too!!!! Thank you for your support
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