The Great and Powerful Oz

CurtainHi. I’m calling to update my prescription coverage and to get my refills ready for pick-up.

I was excited. Our new insurance prescription coverage was so much better than the last one and finally, I’d be able to stop cringing when I handed my money over to the pharmacist for insulin and strips.

Christel, I’ve got them all ready….wait…your new insurance is denying the amount of strips on your prescription. They are saying that you can’t have that many per month. They’ll authorize…

Oh, you have got to be kidding me.

50 strips per month.

50 strips.

Less than two blood sugar checks per day, so you better make it count. 

I thanked the pharmacy tech, wryly laughing as I explained that I knew I had to call my insurance company.

Hi. I’m calling to find out what I need to do to get an override for your ridiculous assumption that a Type 1 diabetic on an insulin pump can get by on 50 blood glucose test strips per month.

My Glenda The Good Witch demeanor was melting faster than you can say: “And your little dog, too!”

Christel, you’ll need to have your doctor call in to this special number and speak to The Great And Powerful Oz (but don’t look behind the curtain because I’m sure it’s someone who thinks Type 1 diabetes could be cured by a brisk walk and some cinnamon). They’ll review your doctor’s request and make their decision.

(OK, so that wasn’t exactly what she said. I may have taken a few liberties, but truthfully, I was conjuring flying monkeys and donning my striped socks so I wasn’t listening intently with both of my green, pointy ears.)

I thanked the customer service representative, but I wasn’t laughing anymore.

50 strips.

And Oz, the Decider of my Strip Amount per Month person doesn’t know that today, despite being on a CGM, I’ve pricked my finger 14 times today because I’ve run from 324 to 38 (and all points inbetween) in the last 12 hours alone. And not on purpose, lest you think I’m wasting strips for no good reason.

I get that Type 1 diabetics are special and that the majority of diabetics in the world don’t check their blood sugars as often as we do, but my doctor wrote that prescription for more than 50 strips per month for a good reason. She is going to have to call to justify why she wrote the script and why I need more than 1.66666667 strips per day? She went to medical school. I’m going to take a wild walk down the yellow brick road and say that Oz didn’t, and yet, Oz will decide what’s best for me.

There is something very wrong with this. Wrong.  I can’t wait until we start in on my other supplies that help keep me alive and healthy. I foresee a “first name basis” conversation with many an insurance rep in my future. Like I have nothing else to do.

Even better?

I can’t even pet Toto and say that I’m not in Kansas anymore because it’s the same insurance company we had last week. Just a different plan. It’s not like I magically became another person who didn’t need the same amount of strips I purchased before.

So, Oz?

Meet Christel. And you thought the Wicked Witch was a bitch…

 

 

Everybody Limbo…

HarrowhellI’ve got Dante’s Divine Comedy, Salt-N-Pepa, a few dance steps, AND Chris Farley/Phil Hartman in this post. No need to thank me. Just sit back and enjoy the ride. Or you can get up and dance with me. 

I’ve been under some stress lately.

When I say “some”, I mean a lot. I’m not going to quantify it (as if I could), nor will I have a pissing contest with anyone else about who has more stress in one’s life. (When it comes to pissing contests, diabetics always win. We can drink way more water and pee way more than most.)

Everyone deals with stress differently and I’m not dealing with it quite as well as I normally would.

I’m physically in another state now (mentally…another universe), bunking down with my brother, sister-in-law and adorable five-year-old niece (who can run mental circles around me any day of the week). They are all saints for opening their home for me and the munchkin while we are looking for a new place to live. (And John? Saint himself for spending as much time with us when he’s not at work and then driving back to his own brother’s house at night because there isn’t enough room…)

The house we currently own (in another state) is in contract Purgatory. If Dante wrote about contracts, he’d put them in a circle of hell (A lower circle, but hell none the less.), awaiting the due diligence period to end. In our state, sellers should be given a large sheet of bubble wrap to keep them distracted and an unending supply of Xanax. It turns out that between the time we purchased the house and now, real estate laws have significantly changed in favor of the buyer. As in: even though we have a signed contract and a deposit, if the buyer decided tomorrow that the color of the sky wasn’t the right shade of blue, the contract can be voided and money returned without having to give a reason. I wish I was kidding.

The buyer wants to close in, oh…. 24 days from now. Cool, right? But we have to have a place to live and put our stuff in 24 days. In another state. Without knowing for sure that the color of the sky won’t change, we are in Limbo. (Which is actually a circle of hell according to Dante; the first circle. So, I’m putting us there with the fun pagans who obviously like dancing the… “Everybody Limbo!”)

We’ve been looking at houses and even found one we want (which is tough to do in the are we want to live in), but what happens if we enter into a contract and then our buyer…See where I am going? So, with the gracefulness of a flat-footed elephant, I’ve been trying to dance with agents on all sides to make sure we don’t end up owning two houses. If I can’t get a conga line going soon, we’ll lose the offer on the new place.

But I still have to find a house, because if the stars don’t all align and this doesn’t happen, we can’t live in a van down by the river.

On top of it all, new insurance cards haven’t come in the mail yet (or maybe they have, except my mail is on hold because we are in another state), I need to get appointments to see doctors soon, and my blood sugars have been doing their own versions of the limbo if you’ve seen my Dexcom. (“How low can you go?” was replaced last week with: “Pump up the basal, pump it, pump it….” Salt N Pepa’s version of the limbo song.) Medically, there’s a lot going on, but let’s just keep it at… diabetes is not helping.

I’m told that dancing can help alleviate stress. So, I’m just going to close my eyes, put on some music, and keep limboing until I can’t anymore.

(Promise I’ll be back to my normal chirpy chipper self soon. I am normally that way, right? Right? RIGHT?????)

 

No Feet…

Shoe TreeWe are lucky, you and I.

Whether you are a Type 1 or a Type 2 diabetic or any part of the diabetes community, remember we have come a long way since Banting and Best (and the doggies…thank you to the doggies). We have drugs that keep us alive and kicking along with technology that gets slicker every year. Yes, I kvetch and kvell about how expensive it all is, but when it comes right down to it, I’m so very grateful that we can afford insulin. I love my life and look forward to a long one. (Yes, one without diabetes would be better, but, well, you know…)

You’ve heard that little ditty about: “I complained that I had no shoes until I met a man who had no feet.” Well, I met a woman who had no feet. (She had feet, but you know where I’m going, right?)

I’m currently dissecting our new insurance plan that comes with John’s new job in another state where he is and I am not. (Must. Remember. To. Breathe. Occasionally.) The questions I had regarding coverage of my insulin pump and continuous monitoring supplies had me calling the HR department, where I spoke with a very nice lady who gave me all the info I needed…and more.

We were commiserating about the obvious lack of detail in the documentation that insurance companies give you and how everything these days requires calling them to check on what’s covered. She gave me some great news about my prescription coverage and I shared with her that my old coverage had me essentially paying out of pocket for bottles of insulin and strips until it finally kicked in. She was shocked… and then she shocked me.

“I’m currently in a protracted argument with the insurance company over one of my prescriptions. My doctor said it was approved, but they’re now telling me it’s not. It costs $17,000 every three weeks and they’re denying it.”

Never met this woman, but I can say with certainty that this prescription is not for cosmetic or non-essential reasons. She needs it (or her doctor says that she needs it) and whoa… what do you do? I asked her and her simple reply?

“I keep fighting.”

Life is not a contest of who has it better or worse. I am full of “first world problems” as we like to joke around the house, but as much as I complain about my lack of shoes in the diabetes/insurance sense, I am forever cognizant of those who have no feet.

I don’t know what the solution is (and thank the universe that I don’t have to figure it all out), but there has to be a better way to give those who need lifesaving medication to get the access they need without bankrupting them. (And those who don’t have access to insulin at all? There are organizations to give insulin to those in third world countries, but there are a lot of cracks in the U.S. medical system, too.)

What I do know is this: When you meet someone who has no feet, you help them in any way you can, even if you have no shoes.

That’s why I advocate.

 

Dinosaurs and Good Health Care Insurance…

What do dinosaurs and good health care insurance have in common?

Both are extinct.

DinosaurAt least in my world. I am longing for the days of my youth, when my parents’ health coverage was super-duper. It was like living on Big Rock Candy Mountain, except it was insulin that flowed freely and test strips that grew on trees. I had numerous in-patient  visits to Joslin Clinic and not once did we worry about insurance issues. (Except when a study was supposed to cover labs that were in addition to my normal labs and kept billing insurance for them. That’s a funny story for another time. Promise I’ll get back to that.)

Good-bye Candy Mountain. When I began work after university, I learned about “pre-existing conditions” exclusionary policies and dealt with purchasing insulin and supplies out of my own pocket (and sometimes getting an extra vial from my doctor). Please forgive me for waxing nostalgic, but I remember when I could buy a vial for $30. I wasn’t testing quite as frequently, but I was getting by, waiting for the one year “no diabetes coverage because it was pre-existing” to be up.

I got up close and personal with the ugly side of exclusionary policies when, at 23, I developed pancreatitis and was hospitalized for six days. The ER doctor had written in the intake notes that my blood sugar was elevated and I had ketones in my urine upon arrival, and the insurance company denied coverage due to “DKA”.  It took me making phone calls from the hospital bed and getting records changed to show that I was admitted to the ER and hospital for pancreatitis and nothing to do with my diabetes.  I would have ended up with an almost $40,000 bill otherwise.

Over the years, I’ve had some good health care insurance plans and some not so good, but now… I’m staring into the abyss of the high care deductible insurance plans that are all the rage these days. I’ve talked about how expensive it is to take care of diabetes, but as John will be changing jobs soon, I’m grimly steeling my jaw at the upcoming changes.

High-deductible health care plans are great if you are healthy. They suck if you have a chronic illness. They’re actually classified as “catastrophic illness” plans and feel like such. More and more companies in the U.S. are choosing to go to these plans, because… they’re cheap. If you’re going to offer a health care option for your employees (soon to be mandatory in 2014 for U.S. companies), this is what everyone says is the cheapest way to do it. You pay a premium, you pay everything until you meet a ridiculous deductible, and then coverage kicks in.

We did it last year. Choices were made that I never thought I would have to do when it came to my health. Priorities were made. Prescriptions have to be paid up front and I need insulin and strips, so no delaying those purchases. Alas, my CGM sensors were shoved at the bottom and not purchased until the crazy stupid deductible was met with a string of surgeries that couldn’t be put off. The same is happening now. I’m not paying $60 for two vials of insulin. I’m paying $296. Don’t get me started on the rest of my supplies.

(I understand why some supplies are expensive. They have to cover the cost of research. But I have an issue when I am told that with an insurance discount (and I know that my insurance does not pay for any of it, thank you very much, so there is no discount…), a particular supply is around $300, but without insurance, it’s $795 according to the packing slip. Who is going to pay that? Not me. Probably not you.)

John’s new job has a “traditional” health plan option that doesn’t require a deductible for prescriptions. I’m sure that there are caps and limits and denials coming ahead. I also wonder when they’ll drop that and only offer high deductible plans. We don’t have an extra $1096 a month to shell out for 7 months before insurance steps up to the plate to pay part of my prescriptions and medical supplies. I’m so angry I could roar like a T-Rex.

Poor dinosaurs. I am starting to understand how they felt.

How do other diabetics deal with high deductible insurance plans? I’d love to hear from other Type 1s who have these…

 

 

 

There Are Days…

The title of this image is "Angry Mop". And it's exactly how I feel today. This low wiped the floor with me.
The title of this image is “Angry Mop”. And it’s exactly how I feel today. This low wiped the floor with me.

There are days when I feel I can take on the world and win.

This is not one of those days.

My blood sugars are fine today. A beautiful straight line on my Dexcom mocks me. “Hey, you’re stable, but you feel horrible. Ha ha!”

I had a minor low last night. My CGM perked up around 2am to alert me of a “70 and dropping” scenario, so I dragged myself out of a warm cocoon, navigating the living room minefield of Legos and things that make noise if you step on them to grab a juice box out of the fridge. A half-hour later, I’m trending up and went back down…to sleep.

I feel like I’ve never woken up, even though it’s mid-afternoon. I’ve got the “hit by a Mac Truck” post hypo blues and it’s really bothering me today. It’s not as if it was a severe low blood sugar. I caught it well before it got into the danger zone. I’m nauseous and tired and dizzy…but yet I know it’s not a “normal sick”, so I can rule that out. It makes me angry that even when I treat my hypoglycemic reactions responsibly (I didn’t “eat all the things!”…), I end up paying for it.

So instead of feeling like I can take on the world, I am focusing on taking on myself.

And I’m losing.

Do you ever feel like this?