January 17, 2013

Hello? Is this thing on?



I have been blogging in my head for months now.  Trust me when I tell you it is some great stuff!  Only problem is that you couldn't hear it could you?  (I think the microphone was on mute.)
 
Well, you are lucky enough to hear what's on my mind today!  Insurance!  I am so grateful for our health insurance, really, I am!!  But sometimes it causes me undo stress.  Why does it have to be so confusing?  I don't get that.
 
Our insurance has not changed.  Not even the copay amount, which seems to have gone up each of the past several years.  Nothing changed.  They sent us a new card, actually 5 new cards!  Yep, I have to carry a separate card for each individual member of our family.  And each of these cards now has a new ID number.  Nothing about our insurance changed.  However, because the ID number changed, EVERY SINGLE doctor, pharmacy, medical supply company, etc, etc, has to re-enter all of the insurance information.  I keep getting calls saying that our insurance is not valid.  It is, they just need the new number.
 
This week, I get a call from the medical supply company that ships Ally's insulin pump supplies along with her CGM sensors.  They need the new info before they can ship her supplies this month.  No problem.  I had to call back as I had missed their call.  After waiting 40 minutes on hold, I spoke with a customer service individual, who had to transfer me to another department because there are sensors on her order...and those are "specialty" items!  After waiting another 40 minutes, I was irritated knowing that they only needed my daughter's new ID number.  Pink cheeks. 
 
The kind woman tells me that we are all set.  "How would you like to cover your copay?  It will be $6 hundred...blah...blah...blah."  Sorry, I didn't hear anything after the words six hundred!  She said that our insurance pays 20%.  Wait!  Our insurance pays 90%!  Pinker cheeks.
 
I told her not to process the order because that cannot be correct.  I immediately called our insurance company and waited another 20 minutes on hold.  She confirmed that nothing had changed on our insurance and her supplies were definitely covered at 90%.  After another call to supply company and another 40 minutes of waiting, I finally got it all resolved.  Same exact copay that I had been paying for the past year plus her deductible.  So basically, I spent over 2 hours unnecessarily.  Red cheeks!
 
I realize this is not the insurance company's fault.  Well, maybe if they hadn't changed those silly ID numbers!  It is just so frustrating!!!
 
This little incident has me thinking about Ally's future.  Funny how so many things have me going there in my head...she's only 9 for goodness sakes!  As I sat there, in my flush-faced frustration, I thought to myself Ally will have to deal with this for her whole life.  And then I began thinking about how I will prepare her for this part of managing her diabetes, so that one day when she does have to handle these insurance incidents, she will handle it with more grace than I did! 
 
So, when I figure out how to understand insurance and get organized with it, I will most definitely begin a plan for preparing Ally for this stuff!  The only notes I've made in my notebook to future Ally are 1) Know your insurance!  Know your deductables, and plan ahead for those - they will surprise you every January if you don't.  Know your copays.  Know what is covered, and at what %;  2) Pay attention!  Pay attention to the EOBs.  Pay attention to the bills that come.  and 3) Be organized.
That's all I've got!
 
In the meantime, feel free to share your ideas for the future Ally about staying on top of insurance :) 



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4 comments:

  1. I completely relate to this and it makes me so sad too. Ughh...what a pain to mess up your mail order supply!! Once I get that set up, I expect it to be right for at least a few months. I think about preparing them for this crapola too and it is just depressing. We won't have to do it forever, but they will. I like your idea of jotting down advice for them on how to handle this...it is SOOO important. Nice to have you back blogging!

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  2. Um, have her sign a HIPA(sp)auth and handle it for her. That is the plan I'm probably going with.

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  3. Isn't it crazy how we have to jump through so many stupid hoops with all of this stuff? Ugh.

    I'm glad you got it all sorted out, and I think you've got a great list going for her.

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