Saturday, January 13, 2018

Health Insurance: A Rant

Ray and I ended last year with the jolly news that our insurance premium was going up by $200 per month. Yippee!! You need to know that this has nothing to do with politics or what our Federal Government is doing or not doing in regards to healthcare. We are in the most expensive group possible when it comes to healthcare costs. We are not yet old enough for Medicare and we are in a group through the Arizona State Retirement System. Catch that? Retirement. There are no young, healthy people in our group that would offset the high cost of keeping us alive and as healthy as possible. (I don’t want to get political in this post but this should be a wake-up call to show what will happen when people can choose to not be insured, and they will. Costs are going to go through the roof!)

We’ve been dealing with rising costs for a few years now but it has now reached the point where I’m contemplating taking my Social Security early just to survive. It sucks. It pisses me off. And yet, I am so thankful to have said insurance, whatever the cost. We could be bankrupt by now if it wasn’t for insurance. Sigh.

Now let me rant. Our insurance company has added a new twist to our coverage; one that our group admins didn’t do a very good job of explaining. We have a passive enrollment, meaning that if we are “happy” with our coverage then we don’t need to do anything. It wasn’t until we received our new cards that I saw the change. The company has now begun to “rate” doctors and has put them into “tiers”. IF we see a doctor that is in the tier 1 group, then we pay a $30 copay or $60 for a specialist. That’s how it was last year. However, if the doctor you want to see isn’t a “tier 1 doctor” we pay double. Yup, $60 to see a primary care physician and $120 to see a specialist. Someone like say, Ray’s cardiologist or his primary care doc. Excuse my language, but FUCK THAT SHIT!

I get it. I understand that the insurance company is trying to cut costs where they can, however, they are forcing us to go to certain doctors. They are MAKING OUR HEALTHCARE DECISIONS FOR US! I know that there are perfectly good doctors out there that, for whatever reason the effing insurance company has decided, don’t make the cut. Maybe they're fairly new, maybe they ask for more tests than the almighty insurance company likes. Maybe they didn’t fill out some freakin form! Whatever the reason, I hate it. It makes my blood boil. (Too bad that boiling blood doesn’t reduce blood glucose levels.)

As many people have experienced, ad nauseum, I have bumped up against “preferred prescriptions”. When I went to fill my RX for Lantus I was told that my insurance company prefers that I use Levimir. Of course they do. As it so happened, Sanofi (makers of Lantus) have a savings plan that allowed me to get my first prescription free, instead of over $500. (Isn’t that how drug dealers work? Give you the first bit free so you’ll come back?) That was nice but, why can’t they just make the stuff more affordable to begin with? Anyway, I filled it (Hello, free!) and will talk with my new doctor on Monday to see about Levimir or possibly Basaglar which is remarkably cheaper and has been mentioned by a couple of my friends. I know that I shouldn’t complain. I am remarkably lucky to have insurance (even though it’s costing us upwards of $18,000 per year to have it, BEFORE copays etc!)


I hate health insurance, and I have felt this way for a very long time. I feel that these companies are a huge part of why our healthcare system SUCKS. I hate that they are telling physicians how to care for their patients. I hate that they are making us choose from an even narrower list of providers, which is extra difficult when you live in rural America. I know that no one who can do anything about this is listening but I just had to get this off my chest. I had to rant. Thank you for allowing me to do that.

3 comments:

  1. Having any disease is always expensive.

    ReplyDelete
    Replies
    1. True, I never said otherwise. However, that doesn't make it ok. That doesn't mean that we can't complain and work toward change.

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    2. I used to operate a group health plan and I barley understand the ins and outs of group health plans. What I do know is that hopefully they are more than the sum or their many parts. In this case the PBM's are doing and setting rules for prescriptions. The auto enroll is a mechanism to keep the the customer enrolled without affirmative acknowledgement. Much like any ongoing purchase, we avoid these at our house, yet like you they creep into our life. Damn I hate those things.

      bastards, bastards all

      Delete

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