Fun with Insurance!
Oh Em Gee! You guys, I can’t possibly describe to you the sense of elation I currently feel! I did it!
For months, I have been trying to get the newest version of my insulin pump. It’s a closed loop system, meaning that it will communicate with my continuous glucose monitor (CGM) and will self-regulate. I’ll still take insulin for food I’m about to eat like I normally would, but it would prevent me from dropping while sleeping and catch and address any unusual high blood sugars that I might miss. I can’t tell you how excited I am for this. I have pretty decent control, but it could always be better, and this is the answer. It only took about 20 years for me to take this stuff seriously and I want to do the best I can.
I have had to walk over coals to get here! My insurance company doesn’t like to approve anything. A prime example of that is when I first enrolled with them, I was told my insulin pump and CGM were “medically unnecessary” but that’s a whole story of frustration in itself.
To get anything approved, it requires an insane amount of extra hoops and all I can do is call people relentlessly to keep things moving and make sure they’re doing what they’re supposed to be doing...squeaky wheel and all that. Combine that with my doctor’s office moving slower than cold molasses and I was approaching my wits end. I won’t bore you with all the details, but I made at least 20 phone calls trying to get everything figured out.
My doctor’s office had finally called me to say everything was in order and all I needed to do was call this one company and after I spoke to those people, I’d be able to get my items directly from my pharmacy, rather than in the mail as I have since going on a pump several years ago. It felt like I was at the finish line! It didn’t really make sense because I knew the supply company I have been using carried the upgraded version, but I was just following the instructions I was given. Should have know that people who seem to not care about doing their job don’t always know what they’re talking about, even if they think they do. I wish I had asked questions, but I was so happy to get this call that my mind was racing.
Getting in touch with this company was a joke! The first time I called, I waited for someone to answer for half an hour before I decided to call back the next day, but earlier. I’ve been successful by using this technique in the past, so it was worth a shot. No idea why, but it seems most people don’t like to make these calls in the morning, so thank you procrastinators! Second time I was on hold for an hour! AN HOUR! Listening to the same damn message repeat every 30 seconds about someone taking my call shortly. They didn’t even have good hold music. After exactly 60 minutes, it goes BEE DOO BEEP (you know the sound) this number is not in service and disconnects me! I had a breakdown. How can I be so close to something yet so very, very far from it too!? I cried, excuse me, sobbed for a few minutes. I am a stress/frustration crier. I hate it. And when I feel defeated, I need to let it out before I can regroup and think clearly again. I thought it was sweet that the dog was coming to comfort me, but in reality, he shot me with a side eye as he went upstairs where it was quieter. He might have rolled his eyes too.
I took the rest of the day to assess my options. And for like the hundredth time, called my insurance company to verify if they had or had not received the information from my doctor for this stupid prior authorization and they confirmed they had not. Which was confounding since my doctor’s office indicated everything was all set. I called my doctor and left another impatient message. I hate to be rude, but this was borderline ridiculous, and I had a timeframe in which this needed to be completed, and it was nearing the end. I always give them a few days to respond, I understand I’m not their only patient, but also, there is a department dedicated to prior authorizations so it should not have been taking this long.
The next day when I got the mail there was a letter from my insurance company! Dated a week prior! Stating that they have approved everything and here’s the authorization number. I didn’t know what to think! Maybe incredulous is a good word to describe it. How could the person I spoke with just yesterday have zero clue as to what was going on?! All they do is look up my information!
Immediately I call my supply company and ask if this is what I’ve been waiting for. Indeed it is! This helpful person said he’d call my insurance company and get it all worked out and call me back. And he actually did! I couldn’t believe it! Someone did their job!! The sense of relief that swept over me was immense. I could have cried! But didn’t. I fought so hard for this, and to finally have success was amazing! Sweet relief! And as I currently type, I’m wearing the new system! Still learning some things about it, but I was too excited to wait!
Side note: my doctor’s office never called me back 😊
11/2/2022 07:42:08 am
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I use my personal experiences to try and help others navigate through life's trials and tribulations.