An open letter to our insurance company

Dear Insurance Provider,
I’m mad. I’m fed up. I’m ticked.
And it’s all your fault.

Let me start with a few compliments before I go insane-white-woman on you voice my concerns about a current matter that demands your attention.

While I am very grateful that my family has to pay an arm & half a leg for insurance, I am also quite annoyed with you at times.
When we receive various medical bills of astronomical proportions, I do a little happy dance — because I know we don’t have to pay the absurd amount charged. For that, I am grateful.

I can’t complain; several $50,000+ surgeries and we were required us to pay much less than that.

Once, I received a detailed hospital summary from a surgery my husband received, and I nearly passed out laughed out loud. It’s ridiculous – the amount hospitals charge for ONE Tylenol tablet. And medical instruments – don’t get me started. The surgeon required ONE tool out of a kit; and we were charged for the entire kit. An insane, absurd, heart attack-inducing laughable amount.
Again, I’m thankful that we don’t really have to pay these inflated charges.

When I pick up prescriptions, I always scan the “Your insurance saved you xxx” line. It’s usually an insane amount, too. It makes me giddy that I save over $360 on my insulin and $350+ on glucose test strips monthly.
My husband’s Temodar, for example, retails at an asinine amount; $46,919.08 last year. You paid 99% of this for us. Which we, again, sincerely appreciate.

Each time my husband receives a radiation treatment, which is five days a week for six full weeks, you receive a claim from our radiation oncologist – for $2,343. Each time. That stacks up to an amount slightly over $70,000. Granted, you have a much lower contracted amount at $945.48 — and we don’t pay a cent.
For that, I am grateful. Happy. Ecstatic.

There’s a lot of things we didn’t have to pay for, or we pay very little for.

So what do I have to complain about?

Hoops.

The giant, enormous, red-tape clad hoops we have to jump through to get medications approved.
I understand you want us to take a less expensive medication. It costs you less. In turn, it costs us less.
I fully understand that.

Temodar is chemotherapy. It makes my husband extremely, and mostly unbearably, nauseous.
We tried a less expensive drug to combat nausea. It left my husband with migraines – which also cause nausea.
So we were given a prescription for another anti nausea drug. It worked like a charm.
Our problems were alleviated. Mostly, anyway.

The problem?
We tried to refill the drug at our local pharmacy, only to hear “You need prior authorization and you’ve met your monthly limit for this drug.”
What? How can this be?
You will only allow us to purchase 14 of these pills per month. Seriously?
My husband needs two of these pills daily. So, we get a full seven days without dramatic nausea.
He tries to skimp the doses and take only one pill per day to make his prescription last longer. He’s still mildly nauseous. He’s still feeling miserable.

You could fix it, though.
You could allow us to receive a full month’s dose – a mere 60 pills.
I don’t think that’s too much to ask.

Our oncologist has submitted paperwork on our behalf, trying to keep my husband from feeling like roadkill for the majority of the month. And you haven’t really done your part to help. Well, you know, besides keeping us from paying full cost for radiation treatments, MRI scans, CT scans, other various medications and the like.
As you sit behind your large, expensive mahogany and glass desk, do you consider how some of your policies really affect people? How your little red-tape and titanium hoops keep people from feeling the best they possibly can?

Does it keep you up at night?
I doubt it.
But it keeps us up at night.
And in particular, it keeps my husband up at night as he’s running to and fro the toilet to vomit.

Our copay may be low.
But we’re paying more than full price in the long run; our sanity & our precious time.