Thursday, April 17, 2008

Health Insurance

Okay, let me start off by telling you all that (most of you know anyway) I have tummy problems.

When I was younger they diagnosed me with ulcerative colitis.
It has sinced "morphed" for lack of a better word, into Crohns disease, pretty much the same thing except I'm older now and that's just what they call it.
And I won't lie to you, when it's acting up it sucks. Intense pain, no control of bowel movements...etc etc.
I won't go into the nasty details, but I had to tell you that part of the story to move on with the next.
(Anyway, fear not faithful stuff about stuffers, everything is fine, I'm fine, it's all good.)
But the reason it's all good is due to this medicine I'm taking called Remicaid. I have to go to the docs office once every six weeks and they actually do an infusion of this medicine thru an I V.
It takes about 2 or 2.5 hours to do, which believe me if you've been thru this lovely little sickness, it's well worth it.
So, I've been doing this for over two years now and it has worked wonders. What it actually does is supress my immune system just enough so the anti-body's that fight disease in your body don't go crazy. My immune system is way over active, and that's what causes all these problems. It thinks something is attacking my stomach / colin when actually nothing is there.
Luckily for me I have really good health insurance at Sprint, I pay a co-pay of 40.00 every time and my health insurance picks up the rest. (Just an FYI these little trips to the docs office for this medicine run about $5,000 a shot.) But like I say I only have to pick up the 40.00 part of it.
Well, yesterday I get a bill from the docs office for......you got it....4560.00!!
As you can imagine I was a little less than happy. I go ahead and give the docs office a ringy dingy, to find what the frick is going on. I get this big cock and bull story about how my "great" insurance company wants all this information now about why I'm taking this medicine and if I really have Crohns disease and on and on and on. So they had to go ahead and bill me for it, until it gets straightened out. And I said, "Well, I'll just go ahead and give my insurance company a ringy dingy and we'll straighten it out right now."
Now, keep in mind that I have another treatment coming up next week, and I'm really not wanting to go in the hole 10,000 if they aren't going to cover it. But here is the kicker, they have ALREADY paid for my first two treatments this year.
So, while I'm talking to the dumb ass insurance cust. serice rep. all of this came out during the conversation.
She said, "Our investigators like to check up once in awhile to make sure everything is on the up and up."
And I went, "Oh really, because I have nothing better to do than to fake a sickness and go to a docs office and sit there for 2.5 hrs with a needle hanging out of my arm once every six weeks. Not to mention the fact this stuff isn't a narcotic or anything, or the fact it is 5,000 dollars a pop and I'm pretty sure my doc isn't just handing it out to everybody that says they have a little tummy cramp. Why don't you guys let the patient know you're "investigating" them and what is going on before you let them get a 5,000 bill and have a heart attack....then you'd really have something to pay for wouldn't you?"
Anyway, she looked up all the stuff and said it would be fine.
Now, wouldn't that have been easier just to do in the first place?
Anyway, have a good one everybody!
SUPPORT THE TROOPS!!!
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D C
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