It’s Monday … start of a fresh new week … and it’s just barely noon.
And I’m in tears. Even my Westie, who is an empath, is feeling the agitation!
Managing diabetes is HARD! It is challenging and often illogical and frequently a huge imposition on my plans. But OK, I can deal with it. It is what it is and getting upset only makes it worse.
But dealing with INSURANCE and DOCTORS’ OFFICES and SUPPLIERS and PUMP COMPANIES and Big PHARMA … now that takes the cake (so to speak)! It’s enough to reduce me to tears today.
My supplier decided to reduce my 3 month rx to 1 month at a time … REALLY?
My insulin pump company went out of business and all the other pump companies jumped it to offer conversions to us orphans. But the deals all come with restrictions and disqualifications. One company offers a reconditioned pump and you only have to pay $1200. Another will sell you a new pump and give you $400 towards any copay … kinda helpful. A third will allow you a pump in exchange to run out the original warranty but no options for trade-up as they offer their “real” pump customers. And the fourth, perhaps the best, is a free pump and one month of supplies. Heaven help you if you are covered by Medicare … all deals are off, due to the Federal Anti-Kickback Law recently passed … in which if a pump company offers help on a conversion, it appears to be a bribe! Really!?
And my endocrinologist’s office is beyond difficult to deal with. I love my endo … but it is so hard to get a call back or paperwork for pump supplies or rx’s … it often takes 3-4 calls and an escalation to the office manager.
OK, I understand … get a new endo with a better office but most are similar. They are overloaded and I am grateful for their care. But it shouldn’t be this hard!
The number of hours per week that it takes to resolve prescriptions, appointments, insurance, etc … time on hold, time waiting for callbacks, time on voicemail, messages that only say “call me back” without content … it amounts to a part-time job!
What is the solution? Do you have ideas?
As endos have offloaded pump management to CDEs, perhaps there needs to be another specialty ombudsman to interface and expedite the medical care and supplies? After all, diabetes is a life threatening disease and it often feels like the services we must deal with don’t feel the urgency or the need to do their work efficiently and correctly the first time.
This is an important topic. The number of people diagnosed with diabetes is growing by leaps and bounds. The current system (insurance, Medicare, FDA, pharmaceutical companies, DMEs, CDEs and endocrinologists) is already not working well. What will happen as more PWDs need services?
More tears and fear!
From PF:
Sooooo True….
I just got a EOB from my insurance company not covering any of my supplies from march because they say I wasn’t covered… Well… they cashed the check but I guess that doesn’t mean anything. Actually this has happened before. With every change of insurance mandated by the government, every doctor and lab need to bill to a different account…AND they don’t. My fourth change (of the changes we weren’t suppose to have) is coming July 1… URGH…..