Tuesday, May 18, 2010

Insurance Frustrations

If you suffer from Lymphedema, you more than likely also suffer from anger and helplessness...against your insurance company. Despite providing my insurance company with plenty of information regarding all of my doctor's visits, diagnosis, medical records, prescriptions, etc., my insurance company without fail either delays payment of legitimate claims that should be processed immediately or they will not cover the claim at all. In fact the most frustrating thing about dealing with this condition is the lack of humanity expressed to me by my insurance company.

Example: For the fourth time now, I purchased compression garments through a company. When I received the invoice, I sent my insurance company the RX, the diagnosis code and the invoice. Despite this being sufficient for all previous claims, they now have an issue and since I did not have the medical equipment companies submit the claim, they may not reimburse me for the $250 worth of compression garments.

I have learned this the hard way time and time again: be psychic when it comes to your insurance. No just kidding, but I am nearly serious. You need to think of all of the questions that are possible. I called and spoke to a rep days before I purchased the compression garments to ensure that they would be covered. I asked his name (also record their name down and date and time spoke to them), how much the insurance covered, how to submit the claim, etc. The rep failed to tell me that the medical equipment companies need to submit the claims or the proper way of submitting the claims. Despite that they have covered my previous claims and did not alert me that it was an improper method of submission, I continued to submit the claims myself.

I am not sure if there is a resolution to this problem with the insurance company. I will continue to push my point and most importantly, speak with a supervisor.

At times, I feel utterly hopeless having this condition. Insurance coverage, hospital visit costs, doctor visit costs have set me back considerably. When we are trying to push through the feelings of despair that our lives have forever changed with this condition, we also have to fight to have our insurance cover the cost of managing the condition. We have met doctors who have been wonderful and those that have blown us off or misdiagnosed. We have been looked at by others differently and we have looked at ourselves differently.

I also try to be positive because crying or punching a wall after I get off the phone with the insurance company does nothing. I guess we just have to keep going. Try to remind ourselves that things will get better, maybe insurance will get better or our condition will improve. If none of those things happen and we are left hopeless, may we be lucky to have the support of our family and friends.

Sometimes it is not enough to take each day as it comes but instead we feel we need to take each minute as it comes. We are luckily not going to die from this condition; we just have to fight to keep going. If you can make it through this, imagine what else you can cope with and overcome.

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