My insurance makes me want to punch myself in the face

Okay. I need to vent.

I can take a lot, but the runaround I am getting with my insurance re: my  meds is so over the top it’s absurd. And they are making me use express scripts, a  mail-order co, that takes 2-3 weeks from time of order to arrival at my doorstep. The more expensive the medication, the more runaround they give. Like, for example, when it comes to crin.one:  suddenly, my RBA nurse is “ineligible” to order it for me—while she was certainly eligible to order other (less expensive) things for me before. Makes. No. Sense. And with the crin.one, they say I am “locked into one pharmacy,” but that also doesn’t make sense for various reasons I won’t go into. I am not allowed to order all of the medications I need at once, but have to do it piecemeal, which makes me nervous, because I have had so many troubles getting claims approved that I’m constantly worried that I’m going to be out of a medication when I need it. It’s the Wild West of claims approvals—one day they approve, the next they don’t. Last month, they approved fol-gard, this month, they aren’t (just found out that it’s because the pharmacy doesn’t have the generic, fabb tabs, listed as an alternative to fol.gard, and my insurance won’t cover fol.gard.Their bad, but now I have to get a whole new prescription from RBA for the generic, wait a week for processing, and I won’t get them time for leaving for Atlanta.) I checked and double-checked that all of my meds would be covered a long time ago. Actually getting them should not be this hard. I want to ask the Powers That Be: would you be giving me such a runaround for vi.agra?

But the worst part of dealing with insurance is that the thing I am most frustrated with has no face or name. The customer service reps are just frontline soldiers, taking on the most hostile fire from subscribers, and probably getting paid very little to do so. I now humbly admit to losing my temper in major ways twice now—the second time just an hour ago—to one of these frontline soldiers. I’m sorry. This is one of my very worst triggers. If I could berate a CEO over there, I surely would. But I really have to cool it. I feel so guilty when I take out my frustrations on a rep, not okay.

Also today we found out that the lovely dude  at the NYS dept of taxation has greatly reduced our eligible medical expenses for 2012. This is our never-ending tax audit story. Long story short, he is figuring in a refund we got from CCRM that had already been figured into the receipt! We had explained this before. He also seems to have not counted five thousand dollars worth of pharmacy expenses that are clearly listed on an Rx receipt linked to DH’s credit card. Again: Makes. No. Sense. I spent an entire week gathering documents to prove that DH and I lived together in 2012 (because we were not married yet, we had to prove that we lived together the entire year). With this NYS adjustment, the IRS will now want back some of the refund they gave to us already. It’s such a racket, guys. We paid these expenses, and I was DH’s dependent, and we did live together that whole year. We’re legit, not trying to pull anything over on anyone, of course.

Sooooo I come back to my center. I think of the following:

  • At least I know for sure that all of the medications are covered. They might screw up claims, and the process of getting them to my doorstep might take long and force me to try to see three weeks into the future, but I am smart and can figure it out. I just can’t let the stress do me in. Not. Worth it.
  • At least NY State finally accepted our mountains of proof that I was DH’s dependent and we lived together in 2012. At least they are approving sixteen thousand dollars worth of the expenses. And if we amend our IRS return, we will have to pay back part of the refund, but we’re still coming out ahead more than behind.

Money. It’s a killer for me. The sense of injustice I feel about money matters, when it comes to infertility, is very deep and fiery and destructive. I have to exert everything in me to tame it. Which I shall do right now with a walk and some yoga.

Thanks for listening, friends! (By the way, I think I might have been unclear on my last post—my transfer isn’t until Friday, March 14th…two weeks to go…)

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19 Comments

  1. How frustrating!!! Nothing gets me more riled up than the obscene capitalism surrounding the infertility world. Kick us while we’re down why don’t you?! Ugh. It’s so unfair. Hugs hun. I can’t wait until 14 March, thinking of you constantly and sending good vibes :) xx

    Reply
  2. I have Fabb tablets, like, whoah. HIt me up if you need!

    Reply
  3. Man, I get a headache just reading it. That’s super frustrating. Deep breaths and yoga help. Exciting! Transfer on 3/14. I’ll keep that in mind.

    Reply
  4. Insurance companies SUCK!

    Reply
    • I keep telling DH they are criminal. He has a much cheerier view of them. But with this last bit, with the Crinone, I think he is finally coming around to the dark side…they suck big giant you-know-what.

      Reply
  5. Preach it sister! You know I take issue with my insurance company–they’ve been employing the same “merry go round” tactics…what are they trying to accomplish? Are they hoping we will give up and walk away?! NEVER! I always ask to be transferred to a supervisor…the last rep kept trying to “solve my problem” and my exact words were “Listen, I’m pissed and I’m going to ruin somebody’s day–it doesn’t need to be yours–so just TRANSFER ME.” F*ck, like infertility isn’t hard enough without adding grief from the pharmacy. Anyhow, may the force be with you, my friend. XOXO

    Reply
    • YES, they DO think we will give up and walk away, blaaarrrr. I’m with you: never. Never ever ever. We pay gobs just to have the insurance, they should at least do what they say they are going to do when you buy the freaking plan. That’s a really good idea to be transferred to a supervisor so you don’t take it all out on the poor rep….of course with GHI, transferring to a supervisor would take approximately ONE YEAR. I’ll still be on hold while giving birth. (:

      Reply
      • Lol, yes I’ve found myself “on hold” for ridiculous amounts of time

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      • Kali

         /  March 4, 2014

        I tried that today and they gave me the highest “supervisor” there, who was worse than the rep (she actually tried to help, third one I tried), and now they’ve had to “escalate”, and promised me a call today which of course, has not happened.

        Criminals. And I don’t care if the reps aren’t “responsible”, they can take the brunt of it and complain to their supervisors.

        Every once in a while I get one who is useful. Otherwise it seems any joe off the street can come in and do the phone rep job–not even sure how long they stay.

        Reply
  6. We’ve been audited on our medical expenses too. I think it was a case of “Whaaaa.. this can’t be real?” by the auditor. So we produced every single receipt. After years of tallying those (insert every swear word possible here) receipts, I just learned last year that I can ask my clinics for an itemized list of expenses. A good chunk of that hard work I was doing, now arrives in one nice package. Of course, I still have other expenses to compile, (meds, etc) but it helps.

    It’s such a piss off that others can jump in the sack and we have to: 1. Go through infertility. 2. Pay the bill for it, and do all of the sacrificing that comes with that and 3. Then get audited.

    Feeling your pain here on that and the insurance run around. Gah!!!

    Reply
    • I know! It’s the ultimate f*ck you, really. There is so much wrong with this situation. All of this should be covered, and all of this should also be easy to claim. The urge to procreate is the most powerful in the animal kingdom—it’s not cosmetic surgery we are getting done, after all; we’re trying to have families! Thanks for the tip about contacting the clinics;that’s what we did with CCRM. We’ll have to get another extension this year—I can’t look at another tax form for a long time. Gah is right. Thanks for the support!

      Reply
  7. Kali

     /  March 4, 2014

    This is my day today. Though I called TWICE to make sure I wouldn’t be booted off my individual plan because of Obamacare, and they assured me TWICE that I wouldn’t be, I didn’t have to do anything, my plan would be rolled over, here I am, cancelled on the renewal date, and they say I have to sign up through an exchange and the insurance will not be effective till April 1.

    Then I argued, called back, they’ll “see what they can do”–we all know what that means.

    I’ll see if going in to an office helps, though they seem to centralize these things.

    I feel beyond defeated, deflated, devalued, and dismissed. I don’t matter. I don’t count.

    Reply
    • This is outrageous. NOT OKAY. It is particularly infuriating that you checked about this. I’m so sorry. I hope you can get it straightened out without too many stressful phone calls. Keep as calm as you can and realize that you are valuable, no matter how these institutions treat us, and you certainly do count….to me, and to a lot of people.

      Reply
      • Kali

         /  March 6, 2014

        Thanks TUT. It’s worse that I feel so devalued at work. I have coworkers that are friends and thought my boss was one but I just don’t see him as one. Funding is cut so they are expecting me to spend less days (I get paid by the day as a consultant) doing the same amount of work–the ultimate disrespect. And yet, I can’t give up this income while looking for a new job, but I now hate it here and I used to like it.

        And one coworker, who is a friend, and does care about me, is 7 months pregnant and beyond insensitive about infertility. I can’t just avoid her, she is 1) my friend and 2) the source of more than 50% of my work.

        So I feel bombarded most of the time.

        Today my period finally came, first time since failed cycle (other than progesterone withdrawal bleed) so now I know why the last few days were so dark–but I don’t see myself coming out of this. I admire everything you’ve done to pick up your spirit.

        Why do people think it’s ok to further stomp on a shattered spirit? It just feels like no one is ready anymore to extend a hand into the abyss to help me up. More “pull yourself up by your bootstraps” thinking probably from people who have never been disappointed. It hurts to hate everyone, but it hurts more to be vulnerable by not having that shield up.

        Reply
  8. Kali

     /  March 6, 2014

    Ugh, sorry, that last comment got away from me and was more self-pity than you need on your blog. So excited about your healthy lining dearest. Hoping mine follows suit after a couple of months of clean eating and adding in yoga and acupuncture starting this week.

    Reply

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