Insurance

Insurance the word that sends me into a complete tizzy. I can not for the life of me understand how they come up with the rules and regulations they follow. The thought process of these entities defies every ounce of common sense. I have dealt with (and somehow managed to survive) through illness despite having to deal with Medicare Medicaid and private insurance, because lets face it they don't make it easy. The reason I say "survive" is because of their complete disregard of logic, for example: When I became diabetic I could only have one vial of insulin a month, even though I was a Type 1 Diabetic and that required two diffident types of insulin to maintain, and only 25 test strips. This sets you up to fail which means hospitalizations which cost money. Then  the coverage provider proceeds to complain that health cost are on the rise and cut us back even more on our benefits. Bankrupt Medicare and blame the patients. I'm sick and tired of the continued bullshit. Apparently each of us need to acquire our own personal lobbyist to go up on capitol hill and stand up for us or better yet we all go together and make the politicians answer for the fucking mess they have created.

All the scientific data reports and the like all say it is better to prevent disease than to treat it, yet at every turn we are held hostage by ignorance. Its not hard, if your doctor who is accredited by the state and federal government  that feels  I need a fucking prescription then that should be good enough for the insurance company to approve me for said drug . I can recall several of these episodes the list is infinite, and I'm sure it will continue to grow as long as our interest as patients is not addressed.

Example number one: Dad's scooter

Carrier: Medicare

Condition:  Two time lung cancer survivor, COPD, lung dissection, type 2 diabetic on continuous oxygen, Arthritis in his feet which keep him from walking with out aid.

Problem: Medicare finally approved a motorized scooter for my father, had scooter for 2 years. Batteries started not keeping a charge and tires needed replacement. Dad calls scooter company for maitainace and the company has closed. Dad calls Medicare and ask them who he may contact regarding his scooter to get repairs. Medicare does not have record of the scooter and dad has no paper work because the company failed to give him any are no out of business. 

Result: Medicare has refused to repair because of no record on file, however they will not let him get a new one because they know he already has one. Medicare has refused to honor a new prescription for a new scooter because he can't replace his scooter for five years. In the meantime while this is being sorted out my dad has no way to shop or get his medicine, because this is his only means of transportation.


Status: As of today this is still pending and my dad does not have a operational scooter.

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Example number two: My friend Mita


Carrier: Medicaid

Condition: Diabetic, Double transplant recipient, Neuropathy, disabled

Problem: Accidentally broke her vial of insulin, Tried repeated attempts to get another prescription filled and has been denied by Medicaid each time because it exceeds her allowable amount for the month. Her doctor has provided her with samples of insulin she has to go pick up. Which is problematic because of her disability

Status:  Doctor has resorted to change her type of insulin in hopes of circumventing the system, and get her a prescription of insulin. She currently waiting on prescriptions.

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Example number 3: Me

Carrier: Private Insurance Medicare Supplement

Condition: Former Diabetic and double transplant recipient

Problem: Cut off within a week of acquiring insurance because Medicare did not report my transplant. Reinstated insurance the following week. Tried to make me pay a penalty for getting insurance at time I was not eligible, which was not true. Threatened a second time to cut me off because of they stated I had no drug coverage for more than 63 days. Billed me a late fee for not paying in September even though  I could not pay till the policy was processed ( I acquired insurance on 9/1/2014. )

Solution: Countless phone calls between the agents and the carrier and a trip to the doctor to get a statement signed to reinstate my insurance.

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These are just a few examples of the complete chaos and stupidity that spews from these agencies that are supposed to care for us. Clearly Obama care has fell flat on its collective ass, and I know there are issues and I certainly do not pretend to know how to fix it, I do know however that they can not remain as they are. Times they are a changin'.... And the sooner the better!! Clearly it boils down to money......Perhaps that's why I can't grasp the way these angencies think, because I value people more than money. My only hope is that we can somehow get these insurance angencies to see us as people not a meal ticket.