Have to vent
05-08-2006, 01:12 PM
#1
Member
Thread Starter
Join Date: 04-27-2006
Location: KS
Posts: 37
Have to vent
My son, who is 9, was diagnosed with an ulcer 3 weeks ago. The doctors are trying to determine what is causing this. It has been a slow, frustrating process. As a mommy I want to know what is making my child hurt and how to fix it. It doesn't help that we have a history of stomach cancer on my side of the family.
In the meantime, the doctor has prescribed a medication to help (so far it has helped some, but has not made him pain free). Our insurance company has taken it upon themselves to NOT COVER this new medication because we have not tried CHEAPER medicines yet. WTF? Since when do insurance companies have the power to dictate what my family can and can not take?
Right now this medicine is costing us $50 a week. I'm not sure how long we can afford to do this. My husband works hard, as do I, but we are one of the many families in America who live paycheck to paycheck. The cost of our health insurance premiums alone is ridiculous, and now they tell us this??
Grrrrrrrr.
In the meantime, the doctor has prescribed a medication to help (so far it has helped some, but has not made him pain free). Our insurance company has taken it upon themselves to NOT COVER this new medication because we have not tried CHEAPER medicines yet. WTF? Since when do insurance companies have the power to dictate what my family can and can not take?
Right now this medicine is costing us $50 a week. I'm not sure how long we can afford to do this. My husband works hard, as do I, but we are one of the many families in America who live paycheck to paycheck. The cost of our health insurance premiums alone is ridiculous, and now they tell us this??
Grrrrrrrr.
05-08-2006, 04:33 PM
#3
Senior Member
Join Date: 09-30-2005
Location: Georgia
Posts: 755
Sorry to hear about your son and the problems with insurance and doctors. I will say a prayer for him for healing and that you will be able to afford the medicine without it putting a strain on your family.
05-08-2006, 04:55 PM
#4
Senior Member
Join Date: 03-20-2006
Location: Newport News, Virginia
Posts: 1,125
It has always amazed me how this country can fight war's, visit Mars but cannot come up with a better medical plan to help our own in a crisis like your's! You have my families prayer's and good Luck!
05-08-2006, 05:23 PM
#5
Senior Member
Join Date: 02-20-2006
Location: Sacramento, CA
Posts: 520
Originally Posted by baby143forever
My son, who is 9, was diagnosed with an ulcer 3 weeks ago.
In the meantime, the doctor has prescribed a medication to help (so far it has helped some, but has not made him pain free). Our insurance company has taken it upon themselves to NOT COVER this new medication because we have not tried CHEAPER medicines yet. WTF? Since when do insurance companies have the power to dictate what my family can and can not take?
The cost of our health insurance premiums alone is ridiculous, and now they tell us this??
Grrrrrrrr.
In the meantime, the doctor has prescribed a medication to help (so far it has helped some, but has not made him pain free). Our insurance company has taken it upon themselves to NOT COVER this new medication because we have not tried CHEAPER medicines yet. WTF? Since when do insurance companies have the power to dictate what my family can and can not take?
The cost of our health insurance premiums alone is ridiculous, and now they tell us this??
Grrrrrrrr.
Also they should be able to tell you how many complaints exist against this Co.--- Don't change Co.s tho as he is sick now and the new Co. will consider this a pre-exisiting illness and won't be covered at all.
If you are using a PPO (sounds like you are) there is a Med. Formulary for the Rx's. Have you Dr check what is on it. This way you're always covered. It's his job to know or have staff that knows. If he is part of that PPO, they have a copy of the formulary somewhere. Dr's also get "perks" for prescribing certain Rx's. It may be part of this issue. If your payments are high, as I'm sure they are, the best way to keep them down is to have the Dr use the Formulary.
I used to be an agent in CA this is how I know this stuff....
I'll keep your son in prayer is it's OK and put him on our Prayer Teams list.
Best wishes,
Craig
05-09-2006, 12:05 PM
#8
Senior Member
Join Date: 04-03-2006
Location: Peoria. Illinois
Posts: 1,747
I am one of those medical bankruptcies, even with health care my wife's catastrophic condition caused over three million dollars worth of bills...but by the grace of God and our medical system she survived... The real kicker is that I gave the hospital a cashier's check for $232,000 in 1984 dollars and 30 days later I was taken to court for non-payment...I had liquidated everything I owned to get the 232,000...the judge gave me 30 additional days and I left the court room, walked across the street to a lawyer's office and started bankruptcy proceedings!!! So much for honestly trying to cover your debts...
The real kicker is that I gave the hospital a cashier's check for $232,000 in 1984 dollars and 30 days later I was taken to court for non-payment...I had liquidated everything I owned to get the 232,000...the judge gave me 30 additional days and I left the court room, walked across the street to a lawyer's office and started bankruptcy proceedings!!! So much for honestly trying to cover your debts...
05-09-2006, 01:23 PM
#10
Member
Thread Starter
Join Date: 04-27-2006
Location: KS
Posts: 37
Well, two phone calls today netted the following comments:
Lawyer friend of the family who lives behind my parents: "We're going through this exact same thing with our insurance company and my wife's arthritis medicine"
and my doctor after I asked what he would do if it were his child: "I'd find a way to buy the medicine."
It's frustrating because we budgeted to switch to this new insurance last year (it was slightly more expensive but we thought the coverage was better - less out of pocket) and now this.
Thanks for all of your positive thoughts. I'll keep you posted.
Lawyer friend of the family who lives behind my parents: "We're going through this exact same thing with our insurance company and my wife's arthritis medicine"
and my doctor after I asked what he would do if it were his child: "I'd find a way to buy the medicine."
It's frustrating because we budgeted to switch to this new insurance last year (it was slightly more expensive but we thought the coverage was better - less out of pocket) and now this.
Thanks for all of your positive thoughts. I'll keep you posted.