Thursday, January 22, 2009

How We See Health Insurance Companies....How Health Insurance Companies See Themselves


Health insurance is a necessary evil. Oh, how I need, but hate health insurance companies. As the mother of a child with various developmental and health issues, I have had my fill of dealings with various insurance companies. Most recently, my husband's job forced us to change insurance companies because they didn't want to have to pay higher premiums (I'm happy they didn't just pass them on to us, so it's a better deal, I guess). And so, I have to go through the process once again of getting pre-approved for my son's extremely expensive medication. And of course, the folks at the health insurance company don't have a clue what they're doing. I called to talk to a customer care representative, and figured, well, let me try not going directly to a supervisor just yet because I haven't had a problem yet... I was told that I didn't need to have the medication re-approved if the process had already been completed with another insurance company. Also, since the same pharmacy would be involved, they would already have all the information about the pre-approval, and all they'd have to do was update the insurance information. Well, that sounded much too good to be true since I had to fight tooth and nail to get this medication approved the first time around because it's extremely expensive...about 20-30,000 dollars per year. I had to call the insurance company every day for several weeks, talking to supervisor after supervisor to find out what was taking so long to get an answer, and to find out what paperwork never made it from whom to whom, etc. It was a nightmare, to say the least. So, to hear that all I had to do was update my insurance information, and this from the insurance company, well, it was like an episode from the Twilight Zone. But, being of good faith, or naivete, I decided to give it a try. I called the pharmacy and they said, oh noooooo they needed approval paperwork from the insurance company before they could proceed with shipping out the medication. Now, already there's been a delay because it took nearly a month for the insurance company to send us our new cards, and we can't do a blessed thing without those cards. Anyway, I've done all I can do so far in contacting the doctor's office, sending them what they need, telling them what they need to do, and getting in touch with the pharmacy to make sure they've done their part. I have to recheck every single day to make sure everyone has done what they were supposed to do. I only have a couple weeks of medication left, so it has to be expedited. What a pain. But, I love my son, and I will do whatever it takes to take good care of him. I've become a much more aggressive person since having my son and having to be an advocate for him...maybe I should thank the insurance companies for strengthening my personality...as a subscriber, I suppose that I am a necessary evil for them too.
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