The Headache that is Health Insurance

PWDs are very familiar with and all-too-aware of the “joys” of health insurance. (The expenses, the hassle, the constant fear of being denied…) I had my own mini panic attack over the last month and am curious what others think the solution is. No – this isn’t going to be an Obamacare praise/hate post. Though, I am excited I will have the flexibility to shop for different insurance and not be denied… or if I want to be a stay at home mom next year, or a part time worker, I don’t have to worry about health insurance for myself come 2014… but I digress…

Anyway, it was time to order my pump supplies from Minimed; the same pump supplier I’ve had for the last 6 years. I recently changed my insurance because of my new job. New hospital, and new doctors. But I’m ordering the same prescriptions. Since I was getting close to opening my last boxes of reservoirs and infusion sets, I called early upon the recommendation of my CDE. Mostly because Minimed had to send the paperwork to the doctors, the doctors sign it and fax it back, and Minimed sends your order.

Since my insurance plan has a hefty deductible that resets at the beginning of the year, I decide to only order one more box of each because I will have to pay full price for everything. (And I didn’t want that giant expense at Christmas time to hit my bank account… only to have to cover it again next year.)

I called shortly after Thanksgiving.

My pump supplies should be here next Friday.

What happened in between? About 3 hours of phone calls back and forth to Minimed, my doctor’s office, my insurance company, and my CDE. Of the 5 Minimed reps I spoke with, no one had consistent information or requests. Only one of them really wanted to help me (the gal who finally overrode my restrictions for my items to ship.)

First I was told that I the authorizations from my insurance (my doctors) hadn’t been received yet. My docs all told me they were faxed on December 3rd.

Then I was told, that even though I’d been a pump user and was simply needing a supply order, I needed to send Minimed 60 days of blood sugar readings, a copy of my recent A1C, and doctor’s notes from the past two months. (I’ve only been on my new insurance for two months, mind you.) I found this to be a bit invasive for a re-order, so the CS rep said, oh wait, there is a conflict on our end; we’ll take care of it, don’t worry. In the meantime, my CDE says “no, why do you need to give them all this? You just need us to send this in, etc…”

So I wait a week and I hear nothing. Called back and speak to both a CS rep and a floor supervisor that says I still need all of these blood sugar results and that my insurance needed to sign the authorization. I cave and send in some really crappy sugar results (which I had, thanks to my Diabetes App) and a screen shot of my most recent labs. I don’t have doctor’s notes, which I think are a ridiculous request, but whatever. I call my doctor’s office back and tell them to send the authorizations again along with all of this other fun stuff. My CDE gets on the phone with Minimed herself and speaks to someone who tells her that the blood sugar thing is all a big misunderstanding and she re-faxed her copy of the authorization.

You’d think we’d be good by now. Nope. I call again on Friday after the floor supervisor emails me on Thursday to tell me that the insurance authorization still hadn’t been received yet, even though we faxed them directly to her. (Seriously? How many fax machines do you own???) I’m thinking that I’m not going to get this order by the end of the year anyway, so I might as well cancel it and just wait until January to push through a larger order. According to this CS rep, my order is “now in review” but has been red flagged because the quantity ordered doesn’t match the quantity approved. (Huh?) And says that I could cancel my order, but I’ll be in the same conundrum come 2013 because I will have stopped the insurance review process. Gahhhhhhh!!!! So I agree to keep the order standing and think about it for the rest of the afternoon. (What if they deny my order? Can they deny my order? I’m going to run out of supplies before they figure it out.)

I call back again later that afternoon and speak with Anita, who actually DID something about it. I asked if there was something I could do to make their lives easier (ha. ha. ha.) and if I needed to order, what I assumed, was a three month supply of my shit, then I’d bite the bullet and pay. I just wanted my supplies and I’ve been on the phone with you people for the last month and nothing is happening. So Anita starts looking through my account in silence, then puts me on hold. I’m on hold for 15 minutes. (And I really need to go grocery shopping.) She pops back on the line saying she’s trying to override my order with a supervisor. Oh – action! Good – I will stay on hold for the next hour if I have to.

Luckily, it’s only for another 15 minutes. She comes back online and says that my insurance authorization was received, but it wasn’t linked to my account. (Papertrail fail!) It’s been approved and should ship in 3 business days (Huzzah!) However, my authorization only covered one box of supplies at a time. (??????) Naturally, I ask that since it seems to take forever to get supplies ordered now, when should I call to order. So she puts me on an auto-fill system which ships my supplies automatically and then she alters the date of processing to make sure there is no lapse in my supplies. Thank you, Anita!

I’m not sure if I just got unlucky with a slew of non-customer service people, or if this is just the state of health insurance today. So I’m kind of anxious to see what changes when EVERYBODY has insurance.

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