Medicine, doctors, pharmacies, insurance and hospitals. You need it all. But in order to get it, you have to practically kill yourself. Ironic, isn't it?
Words can't even begin to explain my emotions and thoughts right now. It started a few years ago when we took my husband's insurance plan at work. It sucked. The premiums were high and the coverage terrible. But it was our only option, since I was leaving the corporate life to stay home. Then when I started working at my current job, I turned down the insurance in favor of the higher salary. But when the open enrollment came around, I jumped in head first, excited to have insurance we could a) afford and b) actually helped us. My boss even still gave me a raise AND the insurance, (because I'm awesome.) But it hasn't been the best start.
Our son takes in INSANE amount of medication. He's in the hospital A LOT. He has a huge TEAM of doctors at several different clinics and hospitals. Before switching insurance, I did ALL of the leg work. I checked to make sure each one was in-network. We checked all of his meds against the coverage website and got prices. I got documentation of our old insurance, we did everything right. I worked with our HR lady and got pre-approval processes started for his infusion early, just so they'd have time to get it all right before he was due.
February 1. Insurance takes effect - our son has a medication to pick up. I didn't have my new card yet, but I called and got my ID #, the group #. I hand it to the pharmacist and it gets entered. I get the prescription (after a L.O.N.G wait and much explaining, re-explaining and a few harsh words) and leave.
February 3. Our son gets very sick. I take him to the immunologist. I get another prescription, go to my pharmacy to get it and they tell me I don't have insurance. SIGH. Yes I do, check the computer, I gave you the info yesterday. Much arguing ensues. I ultimately win.
February 4. Doctor calls and says our insurance is denying the doctor visit AND the infusion because there is a 90 day wait on pre-existing conditions. NO THERE ISN'T. I CALLED AND CONFIRMED THIS. Much yelling ensues with the insurance company.
February 6. Daughter has meds to get. Pharmacy makes us wait HOURS, then as we approach counter, claims we don't have insurance. OH. MY. GOODNESS. My husband gets VERY angry. We start over, as if the pharmacy has NEVER seen us before. Then, the medicine is the wrong price. THEN, it's the wrong dosage. THEN, the wrong address. THEN, we leave before my husband is arrested.
February 9. Doctor calls - Cale's 90-day has been lifted thanks to my having gotten the documentation from old insurance company. Whew. BUT. But...the insurance claims there is not enough "Evidence" that he needs the infusion. They are going to need documentation dating back YEARS on his health (or lack thereof), hospital stays, treatments, doctors, etc. And his infusion is scheduled for Friday. If they don't approve it by TOMORROW, the hospital won't have enough time to order the serum.
Here's where I lose it. Anyone who knows this child knows he struggles. They know how much time, money and sleep have been lost sitting in hospital rooms and ERs with him. They know we declared bankruptcy last year in order to pay for his medical treatment. Anyone who knows him, knows he doesnt' feel good. He's always sick. He has chronic infections, coughs like a barking seal and needs more sleep than any human should. That's evidence. Take your paperwork, your "supervisors," your "policies" and shove them. My son will get his medical needs met, or you will be VERY SORRY.
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