Blue Cross is trying to kill my wife
May 03
CVS called this morning and told Michelle that BCBS called to question the insulin prescription that they approved yesterday.
This is the conversation that ensued with the pharmacy dept.
BCBS: We need to verify that you really need insulin.
Michelle: Uh, yes I do.
BSBS: Why?
Michelle: Because I’m diabetic and I have an insulin pump that doesn’t work so well without insulin in it.
BCBS: So why aren’t you buying syringes?
Michelle: I just told you , I have a pump.
BCBS: But you still would need syringes.
Michelle: The pump takes special syringes that don’t come from the pharmacy.
BCBS: OK, I think that’ll be ok with the pharmacist. We’ll let you know.
Think it’ll be ok? Some clown 3000 miles away who obviously doesn’t know the first thing about diabetes is making the decision on whether or not insulin is medically necessary for my wife. The enrollment forms for BCBS required me to detail every frackin Tylenol we’ve ever taken in our entire lives. It’s not like they don’t know she’s diabetic.
Sometimes I think it’s not the school system turning the country into a bunch of socialists, it’s the health insurance system. Many days, it’s really difficult to imagine how govt health insurance could be worse.
If it had been me, I would have simply said “yeah, you’re right, send me the syringes too”, then carefully printed “courtesy of Blue Cross” on each one, then handed them out on street corners to junkies.
They had to come from somewhere though. You don’t think all those phone and form folks toiling away in health insurance now went to PRIVATE schools, do you?
My brother did a short stint for BC/BS of MN – he couldn’t take their idiotic policies and quit.
“Sometimes I think it’s not the school system turning the country into a bunch of socialists, it’s the health insurance system.”
Yup, yup, yup. I really do think that there is great truth in this statement.
But – “Many days, it’s really difficult to imagine how govt health insurance could be worse.”
LOL. You’ve got to be kidding. I can imagine, and that’s scary.
Well, I was being sarcastic, mostly.
Chris,
Your wife is lucky she even has an insulin pump. My daughter was diagnosed with Type 1 when she was five. My insurance company in Northern VA wouldn’t pay for the pump despite the fact that my daughter took 7 shots of insulin per day. And, the insurance co would only pay for 6 test strips per day (DD uses a minimum of 10). As you know, those things aren’t cheap.
We have since moved to So Cal and we are finally pumping. That was one of the good things about our move. Major bad thing: We have a lawsuit against one of the school districts for telling us, “Take your diabetic problem somewhere else.” Kid you not. This was said in front of my six year old. The public school would not let my daughter enroll. The school wanted us to send our very gifted child to the special ed school. Oh well, at least we discovered homeschooling…don’t think we would have ever done it had the school literally not forced us to do it.
We’re getting a continuous glucose monitoring system in a few weeks. WooHoo!!
JudyBat
Yeah, I can relate. Shining Celebi had to have his wisdom teeth pulled. There were no IN NETWORK providers close by. The lady we spoke with said that since they had a network deficiency they would cover it as in network. We get to the dental surgeons the insurance company called them (not us) to tell them that it wouldn’t be covered as in network and we should go to the provider in Mobile (it was too late for us to change things as Shining Celebi needed to have it done during his Spring Break for college, not to mention it would have been an hour and a half drive v 15 minutes for the provider we used).
So we were prepared for them to only pay at the out of network coverage, BUT they denied the whole claim. We called and “oops they made a mistake they are suppose to be reprocessing it” but now Lord Epa needs his wisdom teeth pulled and we will be going through the whole rigmarole again.