17th January 2008
Please bear with me, this is may be a bit long and I'm panicking.
I got a call today from the Avonex pharmacy saying that they can't ship my meds to me this week as planned unless I pay $1856.65. I told them what they already knew--I have a 3,000.00 medical deductible and a $250.00 pharmacy deductible. They were as confused as I was. They told me to call my insurance company to see what's going on.
The insurance company told me that for 2008, my Group decided to make my pharmacy deductible part of my medical deductible.
Now I have to tell you I am the Benefits Administrator at my work. I work for a non-profit that gets most of its funding from a major national charity, which I won't name. But I can guarantee that all of you have heard of this charity, and you probably give them money. I'm pretty sure it's the second biggest charity in the country. They are, in effect, my employer, and it's their name on my insurance card. I attended the big benefits meeting we had in October, when they told us about our 2008 insurance. My plan had virtually no changes. I have this in writing in my office.
At my previous job, I did medical billing. I also went to school for this, and I'm a certified CPT and ICD-9 medical coder and a certified Medical Compliance Officer. So I know a thing or two about insurance.
I called the pharmacy back and told them what the insurance company said. They were not happy. They told me that my insurance company told them that I didn't owe on my deductible, that the $1856.65 was coinsurance. I have no coinsurance. The pharmacy said that the insurance company probably messed something up, so I called them again.
The insurance company said again that it was my deductible, and that it was my Group (the great charity) who made this change. I asked them if the Group could make this change just for me and not for my coworkers--they said yes, they can do whatever they want. Knowing how insurance companies operate, I don't doubt this. I never recieved anything from my insurance company in writing about this, I assure you!
Because of my high deductible, I also have a health savings account, with a little over $1,000.00 in it right now. As you all very well know, MS is expensive, so my health savings account is drained. I can probably, with difficulty, manage to come up with the rest of it--but I don't have a lot of time. I have three shots left, one of which I take tomorrow. I'm facing the possibility of going a few weeks without my meds.
To make matters worse, I think I may be having an attack. Last weekend I got so depressed that I couldn't even tell you guys about it. I basically sat and cried all weekend. I had a deep sense that something was wrong.
This morning in the shower, every drop of water felt like fire. My skin hurt when I put my clothes on. My joints ache. I feel like I weigh 800 pounds and my left leg is all pins and needles.
Today for my staff I planned a Disability Awareness Training. My staff are all therapists so I plan several trainings for them a year. Ironically, after I introduced the presenter, I bent down to pick up a paper and I had the electric shock sensation that goes from my neck down my spine to my toes, which is the symptom that initiated my getting diagnosed.
At work tomorrow I am calling the insurance people at the charity that pays me to find out what they're doing to me. If need be, I will call the Insurance Commision and the Inspector General, who certified me as a Compliance Officer. I am angry, seething. I hurt really bad. I've been having severe tremors for the past few days. I have an appointment with my MS nurse next Thursday. My stress level is so high right now that I can't go into all the what-ifs like I usually do when I'm anxious. I haven't told my husband yet. The only thing I can do is write here.
Yesterday I talked to a good friend, a former employee of mine. I told her how depressed I've been. Her dad has MS and she understands more than most of my friends. She was encouraging. She told me that I have a talent for persuading people and for getting people to listen. She said I'm a crusader for the underdog. I have always worked with the indigent mentally ill and/or chemically addicted. She said she has all the articles I've written to the local paper on her fridge. She told me that her boss (my former boss) said that one day I will be a pillar of the community, and he wants me to run for some political office and he wants to run my campaign. She told me to start a fundraiser to find a cure, that if anyone can do it, I can. By the end of that conversation I felt so uplifted, confident, and calm. Now I'm wondering how I'm going to deal with just getting out of bed tomorrow!
Please, please, please, I need your support and advice. I am terrified and I have never, ever felt this alone.
I got a call today from the Avonex pharmacy saying that they can't ship my meds to me this week as planned unless I pay $1856.65. I told them what they already knew--I have a 3,000.00 medical deductible and a $250.00 pharmacy deductible. They were as confused as I was. They told me to call my insurance company to see what's going on.
The insurance company told me that for 2008, my Group decided to make my pharmacy deductible part of my medical deductible.
Now I have to tell you I am the Benefits Administrator at my work. I work for a non-profit that gets most of its funding from a major national charity, which I won't name. But I can guarantee that all of you have heard of this charity, and you probably give them money. I'm pretty sure it's the second biggest charity in the country. They are, in effect, my employer, and it's their name on my insurance card. I attended the big benefits meeting we had in October, when they told us about our 2008 insurance. My plan had virtually no changes. I have this in writing in my office.
At my previous job, I did medical billing. I also went to school for this, and I'm a certified CPT and ICD-9 medical coder and a certified Medical Compliance Officer. So I know a thing or two about insurance.
I called the pharmacy back and told them what the insurance company said. They were not happy. They told me that my insurance company told them that I didn't owe on my deductible, that the $1856.65 was coinsurance. I have no coinsurance. The pharmacy said that the insurance company probably messed something up, so I called them again.
The insurance company said again that it was my deductible, and that it was my Group (the great charity) who made this change. I asked them if the Group could make this change just for me and not for my coworkers--they said yes, they can do whatever they want. Knowing how insurance companies operate, I don't doubt this. I never recieved anything from my insurance company in writing about this, I assure you!
Because of my high deductible, I also have a health savings account, with a little over $1,000.00 in it right now. As you all very well know, MS is expensive, so my health savings account is drained. I can probably, with difficulty, manage to come up with the rest of it--but I don't have a lot of time. I have three shots left, one of which I take tomorrow. I'm facing the possibility of going a few weeks without my meds.
To make matters worse, I think I may be having an attack. Last weekend I got so depressed that I couldn't even tell you guys about it. I basically sat and cried all weekend. I had a deep sense that something was wrong.
This morning in the shower, every drop of water felt like fire. My skin hurt when I put my clothes on. My joints ache. I feel like I weigh 800 pounds and my left leg is all pins and needles.
Today for my staff I planned a Disability Awareness Training. My staff are all therapists so I plan several trainings for them a year. Ironically, after I introduced the presenter, I bent down to pick up a paper and I had the electric shock sensation that goes from my neck down my spine to my toes, which is the symptom that initiated my getting diagnosed.
At work tomorrow I am calling the insurance people at the charity that pays me to find out what they're doing to me. If need be, I will call the Insurance Commision and the Inspector General, who certified me as a Compliance Officer. I am angry, seething. I hurt really bad. I've been having severe tremors for the past few days. I have an appointment with my MS nurse next Thursday. My stress level is so high right now that I can't go into all the what-ifs like I usually do when I'm anxious. I haven't told my husband yet. The only thing I can do is write here.
Yesterday I talked to a good friend, a former employee of mine. I told her how depressed I've been. Her dad has MS and she understands more than most of my friends. She was encouraging. She told me that I have a talent for persuading people and for getting people to listen. She said I'm a crusader for the underdog. I have always worked with the indigent mentally ill and/or chemically addicted. She said she has all the articles I've written to the local paper on her fridge. She told me that her boss (my former boss) said that one day I will be a pillar of the community, and he wants me to run for some political office and he wants to run my campaign. She told me to start a fundraiser to find a cure, that if anyone can do it, I can. By the end of that conversation I felt so uplifted, confident, and calm. Now I'm wondering how I'm going to deal with just getting out of bed tomorrow!
Please, please, please, I need your support and advice. I am terrified and I have never, ever felt this alone.