Monday, April 21, 2014

Every Which Way From Sunday


 
As I type this, I’m not even sure that I should. My blogging I feel like hasn’t been very positive lately and that in itself is frustrating. I want to start out by saying that it’s okay to be angry, and I am. I feel like most of the time in life no one ever says that it’s okay to feel or show negative emotions, that it’s a sign of weakness and I believe that’s a load.  I hate how I’m made to feel like I should just let everything roll off my back, that it’s just life so I need to just deal with it. Or, that as a Christian it’s portrayed as a lack of faith. Whatever is what I say to that. I would never wish any of this awful crap on anyone, but  the people that make me feel this way along with anyone who comes up with the cost of anything that we as diabetics need to keep ourselves alive and in good health, it might not be right but I wish that they would have to experience just a month of my life, then see if you still feel the same way you do now. You’d have to be an idiot to feel the same way.
 
Since my health insurance through work changed the first of March, I've been having issues and I'm so frustrated right now with insurance on top of everything else going on. Because I really need something else to stress out about right? Right now when insulin resistance is starting to rear its ugly head! Can’t I just have one issue to deal with at a time? Nope! When I wrote this post, well that lady that I thought was a godsend was not. She didn’t know what she was talking about. Apparently I have to pay my $1,500.00 deductible BEFORE insurance will pay for part of any of my pump supplies or Dexcom CGM sensors. Between last Thursday and today it’s been really stressful. When I called the DME (durable medical equipment) company back last week to get some pricing on pump supplies and sensors I was told that just for the box of sensors that it will be $300.00 + something. That’s only a one month supply!!! And only for one item, I have no idea how much my infusion sets or reservoirs for my pump will be!!! Sigh…. This sucks, I pay so much for insurance and they don’t do jack for me. I’m basically working just to cover the cost of all my diabetes junk, and what kinda motivation is that?! I’m sooo thankful for Brad’s job and how much his boss has blessed us and that we don’t really have to worry about the financial aspect, it’s just completely blows and makes me really, really, really angry.  I feel like this disease is just robbing me/us in so many ways and it’s just not fair. Brad was really great about it the other night when I told him it looks like we have to meet my deductible before insurance will kick in to cover any of these items. He could tell I’d been crying and how frustrated I was and that I was playing the blame game on myself. I know how much all this financial junk really does stress him out an how mad he gets at insurance and doctors and medical supply companies, so I was not expecting the reaction that I got. When I told him that for just the box of sensors it will be $300 + a month and that I have no idea yet how much anything else is but we have meet the deductible he said, “Yes, this does make me really mad, yes this is really stupid that we pay what we do for insurance and they turn around and do this. But, if this is what we have to do to have a baby, a healthy pregnancy and for you to be as healthy as possible then this is what we have to do.”. That was a bit of weight off my shoulders to hear him say that, but today when I talked to our insurance broker through work just to confirm that all this truly is the case, I wanted to scream again and throw a temper tantrum. Crying really does help sometimes. It's no wonder that depression is so high among diabetics. Along with an awful chronic disease we have insurance, doctors, pharmacies and medical supply companies all trying to screw us every which way. I'm sooo over them!

5 comments:

  1. I seem to get depressed about insurance every other month. From your post today, it sounds like you're on a high deductible health plan (HDHP). I am too. The way these work, normally, is that you have an upfront deductible you must meet before insurance starts to help cover costs. Note: if you have copays for prescriptions the copays normally doesn't go toward the deductible, BUT will go towards the out-of-pocket (OOP).

    So, once you meet your $1500 deductible, your insurance will start to pay some percentage of your cost. In my case, it's 80%. The good news here is that once you reach $1500, you only pay 20% of your bills until you eventually reach the out-of-pocket max. Once you reach your OOP, insurance will cover 100%. This is why it's so common for T1Ds to refill all prescriptions toward the end of the year because most of us have met our deductible AND OOP and so it's basically "free" at that point.

    I'm sorry the agent couldn't explain this correctly the first time you spoke with her. I hope my explanation makes sense.

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    1. Why couldn't anyone else that I've delt with explain it to me so simply? That's easy enough to understand. Thanks Katie! I'll look into that.

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  2. I'm so sorry to hear stupid insurance stressing you out! :( You are right, people just don't understand so much of what we go through. It's okay to let yourself be angry - I just wish they didn't give you anything to be angry about.

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    1. Thanks Karen. That was a pretty bad rant. Now that Katie did a wonderful job above explaining her thoughts on how my new plan probably works and I just confirmed it I feel much better. All the upfront cost do bite but just knowing now and not having to play a guessing game or anything is a relief.

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  3. Thought of something else I wanted to make sure you know. If you are on a HDHP, you shouldn't have any office co-pays...because you are essentially paying 100% of all costs until you reach your deductible, offices shouldn't be charging you a co-pay as well. Also, if you are ever asked to pre-pay some arbitrary amount, you can refuse. Never pay for any services or labs upfront. Always ask that it is first run through your insurance. Also, if you are asked by a receptionist if you've met your deductible yet this year, you can answer truthfully, but regardless of answer, they still have to treat you the same. About a year ago my endo wanted me to start paying $50 ahead of time and I told them no. Anyway, just something else to know about HDHPs!!

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