On Insurance Woes and Flares….

On Thursday, I called the doctor to get new scripts for Mariella’s inhalers.  I had called in the Qvar, thinking I had another month on it, but, alas…I did not.  Since I was calling, and the Symbicort was up too…I just had them do that one too.

I went in on Thursday evening, and was told that the insurance company had kicked back the Symbicort.  They weren’t covering it.  They DID give 3 other options of lower cost medications…one of them, she’s already on, the other 2 were also straight inhaled corticosteroids, not a combination med like Symbicort.

So, after having a mini-breakdown at the pharmacy counter…(that they gave me chocolate for, to make me feel better) I got home and called the insurance company and spoke with 3 DIFFERENT people…who all “assured” me that the med would be covered.  I just needed to jump through this hoop or that hoop, but in the end, I’d have Mariella’s medication in my hot little hand.

So, I called one number that I was given, and it was a non-valid number.  I called the main number back, and THEY transfered me to someone else who ASSURED me that the medication would be covered, and gave me an over-ride code to give to the pharmacy.  By this time, the pharmacy was closing, and it was pretty late…so I went to bed, and decided to deal with it on Friday.

I went to the pharmacy on my lunch break…and found out they had kicked it back yet again…so I broke down again…and this time, I ended up a blubbering mess the entire rest of the day.  I was able to pull it together to call the insurance company one more time, and they gave me a phone number to give to the pharmacy to help them get the override code to work, or something like that.  So I got home from work and chilled out for a few minutes until it was time to pick up the girls.  While I was picking up the girls…the pharmacy called and said it was all worked out.

I finally had the medication in my hand, and I was feeling better.  Unfortunately, they want me to begin using mail order for Mariella’s medications.  We use mail order for Abby and Rob’s medication…I’m not ANTI mail order…but I can’t believe that a mail order company would have done all this work for me if I were just “RX#54q95q5439857-4”  To MY pharmacy team, I’m Sara…I’m a mom who is concerned about her kid…and her kid is the cute curly haired moppet who comes in a couple times a month and knows them all by name.  They’ve been with us since BEFORE Abby was born, and have been on this whole ride with Mariella with us.  Thursday, before all the trouble, one of the techs saw me and said “I’ve been on vacation, I’ve missed seeing you guys, I’d hoped you were due in for a visit soon”

 

Anyway…Due to my annoying habit of crying out of frustration, and anger…and add on the fact that since Symbicort is the med that they want her IN PATIENT to get her off of…that I was crazy scared to not have it…so I was literally SOBBING most of Friday…I am now the proud sufferer of an asthma flare.  At least I THINK it’s a lovely asthma flare…I don’t have a runny or stuffed up nose…I DO have a headache and some body aches…but I don’t hurt all over…they feel like “body wracking cough” body aches.  I DO have a low grade temp (100.1F* nothing REALLY to speak of) but I’ve been under covers all day.  It doesn’t FEEL like the flu (because stupid me forgot to get the flu shot…I’m a terrible mother.)  Thankfully, it’s been a good year since I’ve been really really sick…so Rob is letting me lie low…even though we’ve got tons of people coming tomorrow for the “Big Game”  The house will get cleaned, even if it IS all just shoved in piles in my bedroom.

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4 Responses to “On Insurance Woes and Flares….”


  1. 1 kerri February 5, 2011 at 1:33 pm

    Yuck, sounds like it was all quite stressful…and that you’re likely paying for it now with how you’re feeling.

    I hope things turn around fast, you get this insurance mess sorted out for good, and things start going more smoothly. ❤

  2. 2 Kat February 5, 2011 at 2:21 pm

    Insurance companies are no fun. I agree with you about not wanting to switch to mail order. I’d’ve been up a creek a couple times were it not for the pharmacy I use being in town and able to “borrow” me a symbicort from another neighboring town’s pharmacy. Cause winter storms had all but drove the shipping in and out of town to a screeching halt. I understand the point of maintenance meds being mail order. I mean you are on the same dose more or less indefinitely and you use it at a steady rate, and probably don’t have many if any questions at all about it. However, when you are still trying to find your balance of meds… mail order is not the solution. Anyway hope your insurance woes get better.

  3. 4 sarahsasthmablog February 7, 2011 at 3:54 pm

    Insurance companies suck. I get it that they don’t want every Tom, Dick and Harry on the expensive stuff that’s probably overkill, but if someone’s tried everything else and it doesn’t work, and they have it in the record that everything else doesn’t work… what do they want? You to go off the stuff that works and end up costing them MORE in terms of emergency medical fees?

    It’s stupid.


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