So, a funny thing happened a couple of weeks ago i-- I got myself an AD buddy. Someonme had mentioned to me that there was someone else in the department with health problems, but I never made the connection because I didn't know who she was. Anyhow, at the graduate student meeting we're all required to go to before classes started, the grad director asked if we had any questions. I raised my hand and started asking a few pointed questions about the new policy.
You see, my university switched from UHC to Aetna back on August 1st, and in the transition we don't have any information on our policies. In fact, I am STILL without an insurance card and it's been about a month. At the time, we didn't even have a group policy number for insurance purposes, and I was getting antsy. So I started trying to get some answers from our grad director, which is usually a mistake anyway, but anyhow...
"So, I was wondering if we have a university-wide group policy number yet," I asked in the meeting, "because I think I can still at least get my prescriptions with that even if we don't have insurance cards yet. Has anybody heard anything on that yet?" My grad director stammered a little.
"Well, no..." he answered. "I'm not sure..." A woman behind me and to my right perked up at the question.
"What are we supposed to do in the meantime?" I asked as patiently as I could.
"If you keep your reciepts you can get refunded as soon as the policy gets finalized..." he offered.
"But my rheumatology appointments are 375 bucks a visit," I said. "I'll have to just wait. Do you know how much longer I'll need to?" The dark-haired woman behind me raised her hand and started answering all my questions, as she had just grilled the insurance rep the day before and found out as much as she could. After she filled in the entire grad student body on the state of the insurance debacle, she mouthed come talk to me. We met up in the hallway. It was "Mary Beth," a grad student who started the year before me.
"You're seeing a rheumatologist," she said matter-of-factly. "What's going on?" So I told her about what was going on for the last year or so, and that's when she told me that she probably had rheumatoid arthritis or lupus, her doctor (Dr. W as it turns out!) wasn't sure which. And she was on anti-malarials and a few other things right now, and she couldn't get some of her prescriptions filled during the insurance fiasco.
So, "Mary Beth" is a bit of a pro at all this now-- her sister has RA, and she's been dealing with much more severe symptoms for a couple of years now. She knows the ropes with my rheumatologist. She knows the insurance hierarchy at my college better than they know themselves. And she's developed some good plans for balancing work around her health. She says she's nearly normal now, and is even back to hiking, which for RA is a heck of an improvement.
We had a little weird bonding moment in the hallway when we both found out we were having problems with Raynaud's disease. "I call it dead-man fingers," she joked.
"My name for it is 'zombie fingers,' I confessed, and we both laughed. We also both found out we're being treated by Dr. H, which was funny, and we both talked about how cool she is. So "Mary Beth" and I are going to get together sometime and have a chat.
I wouldn't wish this crap on my worst enemy. But I'm so damn glad that I now have someone to talk to who actually gets it. I didn't realize how much I needed that.
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Monday, August 30, 2010
Wednesday, July 14, 2010
Insurance Sucks
The fabulous Dr. H. informed me a couple of days ago at my last appointment that the University has re-bid our student heath insurance and that we're going from UHC to Aetna. I find this to be a prodigious waste of my time right at the moment I'm supposed to be finding out how bad the rest of my life is going to suck.
Okay, so UHC wasn't exactly a walk in the park. Every time I needed some kind of expensive test or imaging service, they required me to prove I was still a student. Then they only gave me 30 days to do it, sent me the wrong forms (or lost them altogether) and the charges would be rejected in just a couple of weeks. I have yet to get a single charge paid in a timely manner with them. On the other hand, they've paid all my charges so far. That's better than things could be-- I could have been stuck with the bill along the way.
Even worse, I'm only going to get in one appointment with my rheumatologist (whom the fabulous Dr. H says is awesome) before the switchover to the new insurance at the end of the month. That means new referrals, new paperwork, and worst of all, I don't know if my rheumatologist is going to even take the new insurance. So I might have to go to someone else later-- and someone might not be a someone that Dr. H knows.)
And, I'll have to find out all the new information on co-pays, specialist visits and whatnot, and if UHC is any indication, it's going to be the end of August before I get my insurance cards. All while I'm zeroing in on an autoimmune diagnosis. Not fun at all.
Okay, so UHC wasn't exactly a walk in the park. Every time I needed some kind of expensive test or imaging service, they required me to prove I was still a student. Then they only gave me 30 days to do it, sent me the wrong forms (or lost them altogether) and the charges would be rejected in just a couple of weeks. I have yet to get a single charge paid in a timely manner with them. On the other hand, they've paid all my charges so far. That's better than things could be-- I could have been stuck with the bill along the way.
Even worse, I'm only going to get in one appointment with my rheumatologist (whom the fabulous Dr. H says is awesome) before the switchover to the new insurance at the end of the month. That means new referrals, new paperwork, and worst of all, I don't know if my rheumatologist is going to even take the new insurance. So I might have to go to someone else later-- and someone might not be a someone that Dr. H knows.)
And, I'll have to find out all the new information on co-pays, specialist visits and whatnot, and if UHC is any indication, it's going to be the end of August before I get my insurance cards. All while I'm zeroing in on an autoimmune diagnosis. Not fun at all.
Tuesday, June 8, 2010
Lupus Testing on a Budget
It's been very expensive on my end to maintain my "I think you might have an autoimmune disease but we're not sure" lifestyle. I bet I have spent, over the last nine years, close to ten grand for various tests, ER visits, antibiotics, and whatnot, and I had super-duper government insurance for four years of that. And none of that spending was my idea. It's rather frustrating to imagine what my new car would have looked like had I been a normal, healthy person.
It wasn't too bad when I had the federal government paying for all my medical insurance as the dependent of a military officer. It really sucked when I was paying $400 a month out of pocket every month for my insurance when my hubby was working as an engineer. As a student...? Meh. It's a compromise. Some things work well, and some things don't.
On the one hand, my student insurance drags its feet, kicking and screaming, every time I have a big budget expense like my gall bladder surgery. I have to prove I'm still a student by sending in a form to the registrar which somehow never quite makes it by the deadline and my claim gets rejected. Then I get to scream at them (which is quite exhilirating.) But I've never had to eat a single claim. It's all worked out.
On the flip side, I've discovered a few benefits to being tested for an autoimmune disease on student insurance that might not be available to the common insured. I shopped around until I found my wonderful student clinic doctor, Dr. H., and I've stuck with her for practically everything over the last four school years. She's gotten to know me (and my prodigious medical chart) and has a good feel for what things I actually need to stay healthy and which tests and procedures are just extras. And, since she works with students a lot, she's very sensitive to the cost issue. She doesn't short-change my health care at all, but she has some nice ninja-esque tricks to keep the costs down on my end.
For instance: at my university, we have a fully-functioning health clinic with a lab, which means that they can do a surprising number of blood, urine, fecal, and skin tests in-house. The way my insurance works is that anything that doesn't need to be sent out to be processed I get done for free. They give the doctors a lot of warnings about running needless tests to keep costs down, but I can still get a lot of my bloodwork done without paying anything out of pocket.
So, here's the arrangement me and my doctor have been using. We built up a nice little schedule of regular testing (about every eighteen months) for the autoimmune stuff, and she stuck mainly to the cheaper tests that can raise red flags and indicate a need to test for other stuff. For instance, I get tested for syphilis to see if I get a false positive result. (I think our campus gets a wholesale rate on STD testing kits or something. Go figure.)
Whenever other red flags raised up (like my funny liver test,) she ran more specific testing in-house.
Whenever she's sent me to some kind of specialist (like the rheumatologist coming up) she anticipates the blood tests she's pretty sure that the specialist is going to order anyhow, and she runs them up front and sends them along with my chart. That way the specialist gets their tests ahead of time and I don't have to pay for them. Nifty, huh? The especially nice thing is that, so far, her forward-thinking has saved me a followup visit or two as well. That's pretty sweet when you consider my copay for a single visit is a hundred and fifty bucks.
So far, I've only had one test that the student health service couldn't run themselves-- celiac disease. But it was still cheaper because the university lab could draw the blood, and I didn't have to pay a copay to have someone else do it.
For other tests, like ultrasounds and whatnot, I never leave the doctor's office without a referral, whether I need one or not. That cuts out any possibility of the insurance denying a claim based on not having a referral ready.
And so, that's one way I've started to figure out how to do lupus testing on a student budget.
It wasn't too bad when I had the federal government paying for all my medical insurance as the dependent of a military officer. It really sucked when I was paying $400 a month out of pocket every month for my insurance when my hubby was working as an engineer. As a student...? Meh. It's a compromise. Some things work well, and some things don't.
On the one hand, my student insurance drags its feet, kicking and screaming, every time I have a big budget expense like my gall bladder surgery. I have to prove I'm still a student by sending in a form to the registrar which somehow never quite makes it by the deadline and my claim gets rejected. Then I get to scream at them (which is quite exhilirating.) But I've never had to eat a single claim. It's all worked out.
On the flip side, I've discovered a few benefits to being tested for an autoimmune disease on student insurance that might not be available to the common insured. I shopped around until I found my wonderful student clinic doctor, Dr. H., and I've stuck with her for practically everything over the last four school years. She's gotten to know me (and my prodigious medical chart) and has a good feel for what things I actually need to stay healthy and which tests and procedures are just extras. And, since she works with students a lot, she's very sensitive to the cost issue. She doesn't short-change my health care at all, but she has some nice ninja-esque tricks to keep the costs down on my end.
For instance: at my university, we have a fully-functioning health clinic with a lab, which means that they can do a surprising number of blood, urine, fecal, and skin tests in-house. The way my insurance works is that anything that doesn't need to be sent out to be processed I get done for free. They give the doctors a lot of warnings about running needless tests to keep costs down, but I can still get a lot of my bloodwork done without paying anything out of pocket.
So, here's the arrangement me and my doctor have been using. We built up a nice little schedule of regular testing (about every eighteen months) for the autoimmune stuff, and she stuck mainly to the cheaper tests that can raise red flags and indicate a need to test for other stuff. For instance, I get tested for syphilis to see if I get a false positive result. (I think our campus gets a wholesale rate on STD testing kits or something. Go figure.)
Whenever other red flags raised up (like my funny liver test,) she ran more specific testing in-house.
Whenever she's sent me to some kind of specialist (like the rheumatologist coming up) she anticipates the blood tests she's pretty sure that the specialist is going to order anyhow, and she runs them up front and sends them along with my chart. That way the specialist gets their tests ahead of time and I don't have to pay for them. Nifty, huh? The especially nice thing is that, so far, her forward-thinking has saved me a followup visit or two as well. That's pretty sweet when you consider my copay for a single visit is a hundred and fifty bucks.
So far, I've only had one test that the student health service couldn't run themselves-- celiac disease. But it was still cheaper because the university lab could draw the blood, and I didn't have to pay a copay to have someone else do it.
For other tests, like ultrasounds and whatnot, I never leave the doctor's office without a referral, whether I need one or not. That cuts out any possibility of the insurance denying a claim based on not having a referral ready.
And so, that's one way I've started to figure out how to do lupus testing on a student budget.
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