Wednesday, February 12, 2014

On Health Insurance Denials



(Photo by Mike Durbin)

My friend Mike has been dealing with health insurance denials. I've been there, too. A few years ago, my wheelchair was denied as not medically necessary. I was overwhelmed with frustration. Why is it that the doctor who knows me and my needs can be overruled by an insurance company -- people who don't know my needs and have never actually met me? Why does this have to be so frustrating?

A few months ago I ran out of insulin before my prescription was due to be refilled and my insurance company said no. I had 28 units left in my pump and according to my insurance company that was supposed to last three days. Um, no. A few phone calls later, everything was straightened out, but worrying about it raised my blood sugar.

Insurance company hoop jumping frustrates me so much sometimes I want to show up in person at my insurance company and say...

Hi. According to your files, I am Client XJ83-56, but my name is really Marie. I'm a person. I'm not a a collection of diagnoses, or data points on a chart. I'm a human being with a family who loves her. I've noticed that some decisions regarding my health appear to be automated. A vial of insulin will last exactly 17.2 days. Insulin pump sets need to be changed every 3 days. Insulin test strips will last 30 days. These data points would work perfectly if I was a robot. I'm not a robot. I'm a human being.

I'm a human being who gets her insulin pump tubing wrapped around door knobs and yanks out a brand new set. I'm a human being who has had a cat chew through an insulin pump tube. I've dropped an insulin vial on the hard floor and watched it shatter. I've spilled an entire vial of test strips in a bowl of soup. I've done these things because I am a human being who does not live a perfect life.

My family pays for health insurance, which is not like car insurance at all. Car insurance is only valuable if something goes horribly wrong. Most of the time, nothing goes wrong, but I keep paying my premium anyway just in case. However, my automobile is a choice. If it gets in a wreck, I can choose to file a claim, or I can junk it and get a new car. Health insurance is different. My pancreas broke down. My nerve/muscle junctions broke down. I can't get a new body. Until cures are found, I have to do my best to live with dignity and meaning despite broken body parts. It is not easy.

Decisions you make about covering my healthcare can make the difference between living a life with dignity, or a life in agony. Now that you have seen my smile, and shaken my hand, will you still treat me like a file number? A broken automobile? Or will you treat me like a human being?

1 comment:

  1. Love this! You should definitely send this to your insurance company's CEO or manager of customer relations, etc. Very well said. Thank you.

    ReplyDelete

Disclaimer

I am not a doctor. I do not have a medical degree. Nothing on this site qualifies as medical advice. These are lessons I'm learning at the University of Catastrophe. What I find to be correct answers in my classes may not be the right answers for you.

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