Tuesday, January 13, 2009

Inusrance companies suck!

You know, just when I think this whole process couldn't be more of a pain in the ass... it is.

It's been 3 weeks since my doctor prescribed Copaxone. And I still haven't received the medication. First, it went through the Copaxone supplier. I've spoken to them about 3 times, received a ton of info in the mail, got the name and number of the nurse who's supposed to teach me how to give myself the daily injection. Then, it was sent to the home delivery pharmacy
that my insurance company requires me to use. This... is where the headaches started.

I first spoke to them about 2 weeks ago, verfiied all my information, and was told they'd call back "in a day or two" to let me know the delivery date. I wait 5 days, nothing, call again. This time I'm told they need more information from my doctor, and they'll "call back in a few days". I wait 4 more days, call, same bullshit. I call back again today...and get this: They tell me it was denied!!

This dude then proceeded to tell me "there wasn't enough proof of the illlness to warrant the prescription requested". I almost blew a gasket. I go "Ummm... I have Multiple Sclerosis. I have MRI results showing 2 active lesions on my brain, as well as test results from a spinal tap that are positive for Multiple Sclerosis. What...do you need me freak'n dead so they can do an autopsy and prove I have it that way?"

He stammered a bit... clearly in shock that this apparently crazed woman on the other end of the phone was losing her mind. "N..No....No. Maybe your doctor can simply fax the test results to us so we can verify and process your claim?" My rage grew even more as I responded "Maybe someone over there should get their heads out of their asses long enough to have at LEAST called me when it was denied, or maybe even called my doctor themselves to straighten this out? What, are you people so stupid that you think neurologists are running around prescribing Copaxone for shits and giggles? I mean c'mon...every junkie on the street is just DYING to shoot up with something that will make them have hot flashes, muscle aches, and possibly puke"

Needless to say...the phone went silent at that point. I'm certain he likely had me on mute while he turned to the person in the cube next to him telling them he had some psycho bitch on the phone. I finally just said "give me the damn fax number" to which he gladly provided I'm sure just to get me off the phone.

So... I called my doctor's office. Surprise surprise, this was all new news to them. Paula, the receptionist there (who, btw, is an angel... I simply adore her) was in shock. "You mean you haven't started your meds yet, because of this nonsense?" I sighed and said yes. She then proceeded to fax both my MRI and spinal results to them while on the phone with me. She told me Dr. Samuels was with a patient at the moment, but she would inform her as well and have her call the insurance company personally to make sure this stuff stops and I get my medication.

Now... I'm back to the "processing the claim" part of the red tape...again. I swear to God, if I don't go completely postal and start bitch slapping the hell out of people before this is done, it's going to be a miracle. I have now been trying for about 6 months to get the treatment I need for MS. It's going to take 6 months of being on the Copaxone before I start seeing results. The last thing I need is my moronic insurance company once again screwing everything up and postponing it even longer. It's just ridiculous.

Which...brings me to my main point. When, in our country, did medicine stop being about the patients well-being, and start being about the almighty dollar? Mind you, this isn't the first time I've had this issue with my insurance company. They also denied a surgery I need last year to repair my stomach. A surgery both my primary care doctor and the specialist I saw said I desperately needed. Yet here I sit, with my tummy even worse, unfixed and in pain. How is it a bunch of yuppies sitting around a conference table, drinking their Starbucks and plugging away at their laptops, claim to know more about ME...what I NEED...to be healthy than my doctors do?

I know I'm not alone in this struggle. Sadly, you read articles all the time about people literally dying while waiting for insurance companies to approve treatment. I don't know what the answer is, but I do know something seriously has to be done in this country to put the care of patients back into the hands of the doctors where it belongs. Insurance companies should not even have the authority to overrule a doctor's more than qualified opinion on what is best for their patient's health, let alone have the power to literally kill a person simply because they don't want to pay for the costly care needed to keep the person alive.

So...that's where I'm at today. Really angry, really cranky, and really wanting to haul my gimp butt to the office of my insurance company and start pimp smacking some sense into people.

*sighs* Be well all.
Mis

1 comment:

  1. Yep, I know exactly what you are talking about. Go outside, walk to the river and look across...they don't have this crap and EVERYONE has health care. And no, they don't wait for treatment of life threatening illnesses...seriously, go talk to a few people over there. They only wait for ELECTIVE stuff. The average wait in an emergency room is a tenth of what ours is. I work with people from Canada, they'd never live here. Our government wants us to believe that they hate their health care...but it's all lies.

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