September
2009
Insurance6
In mid-August, we suddenly (? at least it was sudden to me — it’s possible Bob had known for a while and forgot to tell me) found out that our insurance company would be changing on Sept 1. Not unexpectedly, the new insurance plan is much crappier for the same money.
<rant>
The way we pay for health care in this country is seriously broken. Tying insurance to an employer is a ridiculous system which traps people in dead-end jobs and chains them to for-profit “insurance” companies that manage health resources in completely unethical ways. Capping payments on a yearly or lifetime basis for medicines or treatments that a licensed physician has deemed medically necessary is abhorrent and should be criminal. No one should go broke because they get sick, but also, no one should go broke because they or their child has the misfortune of having a chronic, long-term problem that requires continued outlay of money over time.
</rant>
So this has been a source of extreme stress to both of us and continues to be so, because apparently no one is able to answer even the most basic of questions. We have asked the new company multiple times what happens in 6 months after Dorrie blows through her $25,000 lifetime limit on “durable medical equipment”, a term which includes not just the rental of her ventilator, sat monitor, suction machine, and feeding pump (all of which are durable and should last for years), but also all of the disposable supplies that go with them. No one at MVP will give us a straight answer. Finally, after waiting for weeks, we got our benefits book in the mail, but I cannot make heads or tail of the doublespeak that passes for an explanation of what they will or will not pay for.
I am not encouraged after the horrific time we had just this past week trying to get one of her prescriptions re-authorized. We called in a refill and were told that the new insurance required prior authorization. The doctor tried to fax the insurance the info, they claimed they didn’t get it. Meanwhile, we are nearly out of our current supply. We finally get all this cleared up (after 7 days of daily calls to the pharmacy and the doctor’s office) only to find out that medicaid (the secondary insurance) now needs a re-authorization too. *insert swearing here*.
The doctor’s office seemed to think this was an error in billing on the pharmacy’s part — so we shall see.
It’s ridiculous that there are actual vocational programs to learn how to do medical billing. It should not be this complicated.
Amen! Last week our beloved insurer canceled our group policy with no notice since we paid the amount they told us to pay and not the incorrect amount on the bill (which had a still unexplained “adjustment” of several thousands of dollars.)
The people who claim healthcare is just fine are the people who use it no more than for the random head cold and a flu shot once in a blue moon. They have no clue what the frequent flyers go through.
(September 12th, 2009 at 11:25 PM)
They probably have no clue what the limits of their own policies are, either. And I hope they never have to find out — unless they’re in Congress and vote against meaningful reform.
We’ve been really lucky to have Katie Beckett; without that, we’d probably be on the verge of nervous collapse and bankruptcy both. But by itself it’s not great insurance either.
This is the fourth time we’ve changed insurance policies since Dorrie was born — and she isn’t even 2 adjusted yet.
(September 13th, 2009 at 2:56 AM)
Nice ! And it’s being said every day around the USA by so many others! Hello Congress, anyone in there? I’m lucky I’m in the “head cold and flu shot” group…
(September 14th, 2009 at 9:22 AM)
My last post was supposed to say nice RANT, but the RANT got filtered out!
(September 14th, 2009 at 9:23 AM)
I used to work in Florida Medicaid and I’ll tell you—medical billing and prior authorizations are NOT DIFFICULT AT ALL.
(September 14th, 2009 at 10:39 AM)
[...] as mentioned a couple of months ago, our primary insurance changed at the beginning of [...]
(November 14th, 2009 at 3:53 PM)