We have what is known as "commercial insurance." We are not old enough, disabled enough, or poor enough to qualify for any government-sponsored health care. We are fortunate that my employer pays the lion's share of our health insurance policy cost, but to keep that cost down, we have been given an ever-growing portion of the usage costs in terms of co-payments and deductables.
We do what we can to keep costs down.
We go to in-network providers as much as is humanly possible. We are more than willing to use generic medications when there is a generic medication available. We avoid the emergency room in favor of lower-cost walk-ins when appropriate. Because we don't have government insurance we are allowed to use manufacturer's discounts on all of our brand-name medications, and we also try to stick to what our insurance prefers (if we can figure it out!).
But Babygirl's not a cheap date, medically speaking. And she's not having a great winter. She caught a cold about a month ago, and it triggered her asthma. We started her inhalers right up (we refilled one 5 days ago - that's important to remember later in this story!), but the cough has just gotten to the point where it is merciless. And the beauty of a good asthma cough is that it is a dusk-to-dawn affair. For someone with migraines, a sleepless night of violent coughing is just BEGGING for a headache. And Babygirl never has to BEG for a headache, they just come in and make themselves right at home anyway.
(Prior to this, the headaches had, in and of themselves, been severe enough that we'd contemplated a visit to the ER at least once. She's said a couple of times, "It's like I never had the Botox this time.")
So this morning I logged at 8 in and was told to report to the walk-in at 11. We ran a couple of errands and arrived at 10:30 since our walk-in is rarely busy. THAT was an error in judgement. They are suffering through the same new computer programming we are, and the bad roads made one of the doctors late. We were roomed about 1 o'clock. The doc looked her over, opted for increasing her steroids and starting some nebulizer medication, avoiding unneeded antibiotics and x-rays. I helped by showing her shortcuts in the system to make her workflow more efficient. I've been suffering with it longer than she in my office, no need to make myself suffer excessively off the job as well, right? She sent the new prescriptions off the the pharmacy, where I already had a couple of things waiting for me.
We stopped on the way there to eat lunch, do the weekly grocery shopping, and to get wrapping paper for next year (Hey! We're all out - don't judge! LOL).
Somewhere along the way the pharmacy called and asked if we'd gotten new insurance cards recently. We had, actually, about a week ago, but they don't take effect until after the first of the year, so....why?
They had tried to submit her new prescriptions and had been told, "Oh, she hasn't had coverage since 2016!" The pharmacist pointed out that Babygirl has been getting prescriptions filled QUITE regularly throughout ALL of 2017 up to and including (you guessed it!) FIVE DAYS AGO so what, exactly, are you talking about??
By the time we arrived at the pharmacy she'd already been on the phone for over 45 minutes with some high-school-educated gum-chewing gatekeeping flunky who clearly thought that SHE knew more about the matter than the pharmacist did. The pharmacist, who is apparently a candidate for sainthood, was doing her best to find someone farther up the pharmaceutical food chain. On a Saturday. On New Year's Eve Eve. At nearly (by this time) 5 freaking P.M.
At this point, what we really need to make Babygirl feel better is $3 worth of prednisone and probably less that $50 worth of nebulizer medication, so I'm ready to fork out the cash and let the refill on her antirejection medication and inhalers go for now - we have enough to get us through the weekend and we can take up the fight next week. Next Year.
Crap. Who the hell knows what that stuff's going to cost us next year? January is always mystery month, and I always keep $1000 on hand for just medications in January just in case, but DAMN, I have coupons for those inhalers and I KNOW I can get them for $30/3 months if I can get them NOW and they'll last until April and she won't have another asthma attack until 2019 so I won't need them again and......freak. I need to breathe.
So I take off my jacket and climb the lobby stairs a couple of times, go to the ladies' room and splash cold water on my face (and because I'm feeling like an irritable asshole I raise the blind in the handicap stall window. Who puts a window in a first-floor bathroom?? I feel a little bad now because if some short wheelchair-bound soul goes in there they will NOT be able to reach that sucker. My bad.) and work off some steam and figure that if the pharmacist is willing to waste her day talking to idiots on my behalf, the least I can do is pretend to be patient while she does it.
"At least we aren't almost out of her transplant meds." "That will NEVER happen while I am Pharmacist here." Damn. I think I saw her Cape and Tights peep out.
An hour and a half later, she learns that despite the fact that they have been billing (and getting paid for) Babygirl's medication using a code listing her as person #2 on the insurance card, she is, actually (this week at least) person #4 and should be coded as such. Just like the inexplicable change in mail-order costs a couple of months ago, "It's always been that way" was the only (utterly nonsensical) explanation the insurance company could offer. $114 for her medications (and $75 more for three of mine) and we were out the door.
Babygirl looked at me at this point and said, "I'm really glad I don't have to do this on my own." I felt my own Cape flutter a little. (I shoulda maybe hung it over that bathroom window....)
She just filled her pill sorters while doing a breathing treatment, adjusting the higher dose of prednisone for her lower one for the next four days, and asking, "Are my hands supposed to be shaking like this?"
Yup. Just like my brain is right now.
DeeDee
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