Tuesday, February 23, 2010

Panic!

So I had two (TWO!) panic attacks this week over insurance and diabetes related issues. First, since I had a 90-day waiting period before the insurance at my new job would kick in, I was forced to enroll in COBRA coverage. Talk about a major bummer? Anyway, there was a hiccup in transitioning me from insurance as an existing employee to being covered as a COBRA customer. Same insurance plan, same company, just different designation . . why is this so hard, you ask? Who knows. . .

Anyway, this hiccup occurred at the end of December/beginning of January, at the same time I was getting my new insulin pump and going to a bunch of Endo appointments to get started. So last week, I got a few bills in the mail from my Endo's office for these appointments. This is how I found out about the "hiccup." I also found out that one of the things that was never paid for was my pump! As freaked out as I was about that, they proceeded to tell me that they would go ahead and fix this and send their portion, FIFTY PERCENT, to Animas right away.

Well, that's all well and good but I had been told that I would be covered 80/20 for this pump and it's supplies. So now I'm being told that instead of paying 20% for my pump and supplies (or $1000 for the pump and $120 for the supplies), I will actually be paying 50% plus a $500 deductible (or $2850 for the pump and $300 for the supplies). Um, no?!? I frantically called the Animas rep. He was awesome and assured me that whomever I spoke with was wrong, my portion would only be 20% and he would fix it right away. And, God bless that man, he did. Both he and the insurance rep called me today to confirm that my coverage was 80/20 and that I was right. (Sweet validation!) But holy freakin' Spicoli* that scared the crap outta me!

Then, today, I was trying to find out more about what my new insurance would be like. Changing insurance scares the crap out of me because all of my supplies, not to mention my insulin, are ridiculously expensive and bad insurance coverage can almost be worse than none at all. I have to pick an insurance plan next week so I called my Benefits department to go over my options. I was told that the prescription plan has changed from the covereage that I heard about at my interview. (Oh crap!) From now on all plans would cover generic prescriptions for $15 per 30 day supply . . . and my portion will be 100% for any non-generic prescription. But, I asked, what if there is no generic alternative? ::cough: insulin ::cough:: She repeated, my portion will be 100% for any non-generic prescription.

100%? Of all my test strips. Of all my insulin. And all my pump supplies?

Oh. My. Dear. God.

Insulin is easily $200/month (I use 2 vials/month), test strips are probably $150 (testing 5x/day) and my pump supplies are $600 for a 3-4 month supply. And NONE of it is considered generic. Nor are there ANY generic alternatives. That's close to $600 per month just for my diabetes supplies, not including doctor's appointments, etc. Plus I have to pay some ungodly premium for that crappy coverage ($150/month). What?!?

I promptly had a meltdown and good and well flipped my shit . . . and then I sat down and tried to calm myself. I did some digging and apparently people in the company were rioting over the change (um, duh!) so they created a plan called the "full Rx" plan. It's still $15 for generic but my portion of non-generic prescriptions would be 30-40%, depending on the drug (which still sucks, mind you). You have to specifically ask and qualify for it. And it's an extra $25/month. These are my options for insurance.

And I have a good job.

Working in health care.

Can I call shenanigans?

I'm going to my Benefits orientation next week, where I hope to be enlightened by some truth that has eluded me so far. I'm hoping someone will clarify this crappy coverage and assure me that there is something that I'm missing and really it isn't as bad as it sounds. Because right now it sounds pretty damn bad. We'll see and I'll keep you posted. And if you see smoke billowing from Florida next, you'll know they've pushed me too far and my head has officially exploded.

Wish me luck!
~Layne


*Fast Times at Ridgemont High reference. . . look it up.

3 comments:

  1. AHHHHH! I feel your pain! This just happened to me, you probably remember, with just trying to get my dang pump supplies! I did break down and cry too. It's just too much to handle when some stupid idiot company that is supposed to be there to help you turns and screws you over, or so it feels.

    I'll keep thinking about you! Gosh I HATE insurance companies! Especially when you've got a GOOD job and should darn well have GOOD health coverage!

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  2. Oh no! I would be freaking out too! That coverage is horrible...and making my $500 deductible not seem so bad (I do pay around $85/month for the coverage as well). And you work in health care, so this is just crazy! I could see that a regular company might not understand the benefit of good health coverage for their employees because it costs them, but for a hospital. I really don't understand. Health care costs are not affordable for anyone without insurance and us diabetics NEED our insulin and supplies to LIVE. Not like we have a choice and can just try and spend less on our health. Jeez! Let's hope your head doesn't explode and something new comes to light to help with the crazy expenses. Do they offer a FLEX spending program? We have that at my work and it saves me hundreds of dollars a year using it because the money it taken out pre-tax. The accounts came about specifically because health plan deductibles and out-of-pocket expenses are consistently going up. Makes me worry how hard the costs will be for us in 10 years with the rate things are going.

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  3. I've heard that medical jobs often have the worst health care. Doesn't make much sense, does it?

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