Because I Said So!!! Mom Knows Best!

Date: 12/01/2009
Stress Level: eh, I can live with it!
New Grey hairs added: 1






Today I spent the better part of my day on
the phone, or I should say on hold. It is open
enrollment season for my insurance company
and I needed to change my prescription plan.
The plan I have had for the last four years
has just about driven me insane. I never paid
much attention to it until I found out I was
pregnant. My doctor wrote me a prescription
for pre-natal vitamins and the brand he wrote
me for was denied. So I called him up and he
wrote me another one.


Denied


Another


Denied


This repeated no less then 10 times before I
called the company and came right to the point
and asked them what kind of prenatal vitamins
do they cover.


The answer?


NONE!


I could not believe my ears. They will cover
any pain medication my doctor writes me for my
RA and as much as I want as often as I want but they
will not cover prenatal vitamins. The other thing with
them that left me stymied is I have asthma. Most of the
time it isn't too bad but every couple of seasons I have a
bad spell. A few years ago was the worst it ever was and
I found myself in the ER about once a week and was even
admitted for a few days a couple of times. When just in the
ER they give me a few breathing treatments and a prescription
for steroids and send me home. The year it was so bad I was
there so often it drove me nuts and let's face it I have a
family to take care of and just can't be spending all
of my time in the ER. Even more so being admitted
and spending days in the respiratory care unit. Plus that
unit creeps me out!


After much complaining my family doctor agreed and
wrote me a prescription for the machine that I get hooked
up to in the ER. This way I could do it myself and not have
to sit in an ER for 3 hours wheezing and turning blue just
to be taken to a back room and hooked up to the
same machine she was giving me to take home. I could
also use the machine with my kids there instead of
scrambling for a baby sitter to watch them while John
sat with me in the ER. My insurance had no problem
covering the very expensive machine for home but
what they would not cover was the 200 dollar a month
medication that went into the machine.


Let's recap


5,000 dollar machine OK


200 dollar medication, sorry lady you have pushed it


too far.


SO, back to the ER where that 200 bucks turns into
2,000 dollars a visit and I am there about every three
days. Makes a lot of sense doesn't it? Trust me, I would
rather hook up at home all by myself then sit in that ER
waiting room, freezing, freaking out and turning blue.
I would really rather skip the respiratory care visits all
together and I could if I could treat it when I first have
an attack not 4 hours later. But, hummmmmmm,
my insurance company likes to pay a lot when
they could pay a little. No more!


Moral of the Day: If it costs and arm and a leg
and you really don't need it, your insurance will be
glad to pay!