As the chronically ill know too well, insurance is often SO very frustrating!
I spent today dealing with insurance…yes..the frustration. I refuse to allow insurance to dictate what care my specialists and/or doctor provide to me…their patient. It is my specialists and my primary care doctor that are in the “trenches” with me…doing their best to help improve my quality of life.
I have said this before…I SO appreciate my specialists and primary doctor. I feel truly blessed to have such wonderful medical providers. I most appreciate their honesty. They have each said that my case is “extremely unique….unusual….not really sure how they can help”…yet each one has and is doing his/her best to help me!
Then there is insurance. Insurance TRULY is NOT on the side of the chronically ill…they have no concept on dealing with hidden illnesses and hidden conditions! We do not “fit” into their wonderful “scripts” or their “books”. They choose to have their “doctors” dictate to our doctors what is best for us.
YES! A doctor who has NO IDEA about us! One who has never met us…never seen our physical pain…our anguish…our tears…our frustration…our losses!
I for one am just fed up with this! I am fed up with insurance dictating to my pain specialist that I my pain pump trial is denied because they do not have an MRI of my back! (Yes…you read correctly….they want an MRI of my back with the pinched nerve….SAY WHAT??? Where is pinched nerve in the diagnoses of Fibromyalgia, Polyarthralgia, Chronic Pain Disorder, IBS-C, and Pelvic Floor Syndrome.) I am fed up with insurance saying that the new medicine that my pain specialist thinks will offer some relief must be “pre approved” by insurance…again…they must have the ultimate say if it is correct for me or not. How would THEY know???
So I DID NOT take any of this lightly. I have been in contact with insurance…I was on the phone regarding why they refuse to allow the pain pump trial…I was on the phone with the “prescription drug” arm regarding the pre authorization.
I was told by the “prescription drug” arm that the medication should have been added back in January to my possible drug list…that insurance calls my “formulary list”. Yeah….right…my specialists and/or doctor have a crystal ball! They can look into the future and come up with what will work and will not work. YOU HAVE GOT TO BE KIDDING ME!
Needless to say…I FINALLY got a phone number for the actual insurance itself so that I can follow up with them in the near future. I want to ask them WHY they think that THEY know better than MY specialists and/or doctor who are working WITH me on a regular basis!
All of this frustration TAKES ITS TOLL! The stress exacerbates my conditions which are all ready flaring because of additional infection. The amount of energy it takes is INCREDIBLE!
As an individual living with constant, severe, chronic pain, my extremely limited energy reserves are used to just get through the day…to have some time with my family….on a really good day…maybe even to have a friend come over to visit. Yet I feel it is important to stand up for myself…to stand up on behalf of ALL of us who have to expend energy that we DO NOT have to stand up for ourselves!! To battle not only our illnesses/conditions but to battle our insurance companies for our needed medications and/or treatments.
This IS NOT how the insurance system should work. This is the UGLY side that most individuals will never have to deal with…most can just go along completely unaware. AND, most sadly of all, I worry for those who have chronic illness and do not have the ability, the stamina, or the determination to fight for what is best for him/her!