I have been getting very frustrated lately with the insurance company denying 90% of what my doc orders for me. The bastards make me jump through all these rings of fire (tests), submit this form/that document, jump through a few more rings… and DENIED! Oh but wait! You can appeal the decision… more rings of fire, more forms, more documents… interviews… long phone calls… DENIED again!
Bastards. They are using up all my flippin spoons!
The one new (to me) medication they approved, Requip, didn’t do any good for me. It kept me awake… so that was a bust. Tecfidera and Ampyra have both been denied. Twice.
And the icing on the cake?
I was listening to Obama’s speech today… color me dumb… he was talking all about affordable health care and how wonderful it is. He was appalled there are politicians in Washington who are still beating that old dog (or something to that effect). He couldn’t believe they won’t let it go and worry about more pressing matters.
Obama went on to talk about how much money it’s saving the middle class.
I’m middle class.
He talked about the billions of dollars in rebates sent to folks last year because their insurance company didn’t follow the 80% rule… basically, 80% of the money from premiums is supposed to cover medical care. Only 20% is supposed to be used for adminstrative expenses by the insurance companies. So if the insurance company spends more than 20%, which encroaches on teh 80% to be used for the insured’s medical care… well then the insurance company is supposed to send a refund check for the difference to the insured. For example, if an insurance company makes a faux pas and spends 40% on administrative leaving only 60% of the premium for medical care, then a check for 20% of the premium paid is supposed to be sent as reimbursement to the insured. He also talked about how premiums are lower than they’ve been in years, co-pays are lower than they’ve been in years….
I don’t know about anyone else but I have not seen any of this.
I have not received an refund check. Ever.
My premiums have gone up… and they go up more each year.
My co-pays have more than doubled.
And my coverage sucks… well, the medication part sucks. The treatment part is great because I work for a hospital system.
Have any of you received a check from your insurance company? Has anyone’s premium gone down? What about the co-pay?
I have this great fear that in the next 5 years I won’t be able to afford premiums, co-pays, or medications. In fact, I’m afraid more things ordered by my doctor will be denied. I am afraid this chronic progressive shitty disease will render me invaluable to the American government and therefore, a waste of their time & money.
That’s my fear.