You Get What You Pay For...

You Get What You Pay For

The Perils of Health Insurance

Last year this time seemed like a magical time for me.  I had and was still going to see my long time doctors who knew me.  I didn't have a problem getting a new prescription, a new refill and or a same day appointment. Oh how I miss those days. :(

With new management came new changes. One BIG change for our family was having to change our current health insurance. Now, don't get me wrong. We could have easily stayed with our current, wonderful health insurance...for a small fortune.  My husband and I sat up nights, talked during the days, and tried hard to figure out how to keep our current insurance.

If we had kept our current insurance, there would be a $3,500.00 fee that you pay BEFORE the insurance would kick in.  If that's not bad enough, there is a 10% fee for services, this all gets added into the total $3,500.00.  Now, here's the gist of why this was heartwrenching.  My current multiple sclerosis treatment is approximately $9,000.00 per month.  This $9,000.00 includes nurses assistance, all medical supplies and time in the infusion room and patient monitoring. The insurance is my husband's and once you figure everything out it is literally a cut in pay.  A cut in pay from your employer who hasn't given out even a standard of living raise for five years.  I couldn't and wouldn't do this to my growing family. And under great hesitance from my husband, we signed over to the new insurance.  Again, oh what joy, in my most sarcastic tone. 

Okay, the new insurance started off pretty well. There are $5.00 copays. Okay, manageable.  I was able to find a neurologist to keep the continuity of my treatment up. Okay, another plus.  I was able to link up to a primary doctor for myself. Another plus.  Even though I had just switched doctors for my children with the previous insurance, I found them another pediatrician. He was pretty cool, yet another coup for me.  But, as time goes by, my rose colored glass are turning clear and my husband and I are finding out the hard truth is that you get what you pay for.

Now, on paper, our current insurance, especially for employees, seems great.  But, gone are the doctors who know your case.  Gone are the doctors who really LISTEN.  Believe me, I know my body and my symptoms, when I say I need a script, I need a script.  I don't want a primary doctor to tell me to ride it out.  You know what riding out a sinus infection or any infection will do with a person who has multiple sclerosis and has a compromised immune system?  It causes relapses.  I ask for medications that my previous neurologist and primary doctors have had me on for years. You know why? Because...it WORKS.  But, can I get a script for that medication now with my new doctors? NO.  Their excuse is that they don't know me well enough to provide me the script.  Really? Did you read my chart? Have you spoken to my other doctors? Do you realize that I have a VERY complicated case? Unfortunately, not.  

I am stuck going back and forth, coming in for a visit that yields no answers and no relief.  The scary part is that I am left self medicating because getting a prescription for seemingly anything is impossible. I can't get a script for my fatigue medication anymore, so I am now on liquid Vitamin B12. The nerves swell in my feet, but I can't get a script for neurotin, so I am taking large doses of ibuprofen to take out the swelling of the nerves in my feet.  Anything sedating is pretty much off limits, so my sleeping problems which stem directly from my multiple sclerosis I have to buy over the counter medication for that.  When I am truly sick and need to be seen that day is not an option.  I was sick on a Thursday, pleaded for a same day appointment. I was told that those did not exist.  My appointment because my husband worked for the employer was scheduled for Tuesday of the following week.  They told me if I got worse go to the ER which is ALL the way across town.  I am so frustrated that I could just cry.  Am I grateful for health insurance. For heavens, yes. There are so many people without that I am truly grateful that I have an insurance company that will pay for my high monthly multiple sclerosis treatment.  But I wish that I had truly appreciated what I had with my previous health insurance company.  Oh how I miss them.  Like the saying goes, "You go from sugar to sh**!"