I have to preface this blog with three facts:
1. I am thankful that my kids are healthy.
2. I am thankful Slade has a job.
3. I am thankful Slade's job offers him health insurance.
With that said, I want to vent a little about the ridiculous racket, some may choose to call "insurance." In January we began to pursue growth hormone for Sawyer. He was tested and and his doctor diagnosed him with a deficiency due to the fact that:
1. The 3 hormone levels that produce growth hormone are, in FACT, low.
2. An MRI showed that, in FACT, his pituitary gland (which produces above stated low hormones) measures smaller than normal. (Perhaps that would explain the low hormones?)
3. He is at the 5th percentile in height (which is the exact cut off for the diagnosis). Never mind that his father is ABOVE the 100th% which may explain WHY he is at the 5th% rather than a smaller percent. (Either way, he is not in line with his genetics. Oh, yeah, that's because he has a defeciency.)
The insurance denied the claim. We expected that. Who wants to pay $1500/mo for the next 10 years?
A third party company represented us due to the fact that insurance companies deny it on a regular basis. Claim . . . still denied.
Our doctor wrote a clear letter appealing the decision. He stated he was so certain that Sawyer's diagnosis is correct that he'd be willing to have other endocrinologists review the case.
Insurance denied THAT appeal.
But not to worry, THEY (BCBS) will review THEIR previous decision with more of THEIR employees who represent THAT company?
Does this seem strange to anyone besides me? Where is the neutrality? Where is the independent interest? Who is advocating for us? What knowledge do they have? Where is the other specialist our doctor asked to review the case?
It is so frustrating because, although it is evident to the doctor and to us, the insurance can hide behind their numbers and avoid paying for the VERY thing that insurance is supposed to pay--medical NEEDS!
ARGGGGHHHHHHH!!!!!
It makes me want to call Michael Moore . . .
2 comments:
Go for it Heidi!! Michael Moore, strange that he might be, and having his own agenda, does a great job at getting points across!! Insurance is such a pain. It took six months after Savanah was born, something that happenes several times a day to several people, to finally get all the insurance figured out, and we stilled paid through the nose for her to be born. What the heck is the point of insurance? I sometimes wish I was not married and unemployeed when it comes to having children because then the state would pay for all of it. Go figure!
Yes on the "grateful" part. Also yes on the insurance racket part. Our health care system needs help. SOS . . . save our system!
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