Wednesday, October 19, 2011

Why It Is Very Important Not Be Lazy When It Comes To Your Health Insurance (A Rant & A Ramble)

Long title, huh? This one's a doozy. It might be a bit of a vent session. Mostly just a "learn from my troubles."

When Mitch changed jobs, we changed insurance companies. Oh were we ever so excited about that fact. Our previous insurance was hit-or-miss and we had an absurd deductible. Raise your hand if you've been there. We had high hopes for our new insurance, and were happy to find that our hopes were realities. All was wonderful.

Except for the fact that we are lazy people.

Well, I'm lazy anyway. Mitch is only lazy because of me. Lazy by default.

Our new insurance is special through the state of Hawaii. And just yesterday I found out that though they will cover my Enbrel 100%, I have to follow a few steps first. Steps I should have done as soon as I got my insurance card not, ahem, the day I needed a refill.


So the story goes . . . I call to have Doc Wiz fax over my prescription to my new local pharmacy. Enbrel Day (this past Friday) rolls along and I call the pharmacy to make sure that it's there and ready for me to come pick up.

Problem #1 comes up: the pharmacy will not fill Enbrel.

I made a snarky remark about them not letting me or my doctor know that fact ahead of time and hung up. I then proceeded to start storming around the house, rambling on about the phone conversation, tearing up and pouring myself a drink. Mitch watches, nods his head and makes the appropriate angry noises.

Eventually I relax (that drink might have helped) and decide that I will have Doc Wiz send my prescription over to a pharmacy in WA while I'm up there.

Problem solved.

So I get to Washington. Fabulous. Chat with Doc Wiz's office, tell them the story and they send the stuff to Wenatchee. About an hour or so later I get a call from the pharmacy saying . . . get this . . . it's a no-go on the meds. Your insurance won't cover it. Oh and it's $2000 if you want to just get it yourself.

Yeah, let me just get my checkbook.

Here's where it gets complicated : apparently injectable medicines are a funny situation. My insurance makes it so that I have to have a primary care doctor before I can have any other doctor fill a prescription. A whole bunch of nonsense in my opinion, but ok, whatever.

The problem is that I don't have a primary care doctor. Not yet anyway. I haven't had one in years, mainly because we've moved around so much and Doc Wiz has taken the place of my PC. Anytime I needed anything I went to him. We're tight like that. But I knew it was something I needed to do in Hawaii . . . I just hadn't gotten around to it yet. I mean, y'all know me, I don't trust doctors easily. So because of that I wanted to take some time to shop around for a new main doc. Accept applications. Do some interviewing. Ya know, normal stuff. I guess now I have to speed that process up.

Luckily I have an amazing husband who has been on the phone all day and night getting information, figuring out the process and making us an appointment with a doctor so that we can get the ball rolling and get me my drugs!

The man is smart. He knows not to keep me off meds for too long.

Poor guy.

The likelihood of me keeping this doctor as my PC is dependent on how smoothly she makes this whole mess of a situation. The interview process begins.

The bad news is that since I am out of the state it won't be until late next week, and because of the whole insurance BS it will take about 48 hours after the doc appointment to process all the stuff. That means it's going to be another two weeks without Enbrel. Aye!

Luckily I have no major swelling yet. And hopefully Doc Wiz will come up with some genius idea to get me through the time without. But how fun, right? Traveling and arthritis. The perfect duo.

Thank you for your time. Learn from my lesson. Don't be lazy like me. Good day.

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