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Thursday, September 8, 2011


I had a raging sinus infection (and double ear infections...) last week.
What else is new, right?  Welcome to life lived with Sjogren's Syndrome.  The meds I am on stop my body from fighting infections as efficiently as it used to in order to keep that same body from attacking itself.  Lovely, right?  So I am pretty much SOL when it comes to keeping a cold from moving into my sinuses or my chest and turning bacterial. 

What is new to me is the experience of having the insurance companies dictate what medications I can and cannot take, as well as where I can get my medications.

I guess I am fairly lucky that this is the first time I have run into this.  Though now that I think about it, I did have my daughter's ped look up to see what cough medicine he could prescribe, and my insurance company did dictate where I could get my heparin from while preggers with Charlie...but I have never had the experience of insurance denying a claim for a med that my doctor prescribed. 

I mean really, WTF does that doctor know?  I come into his office, fucking miserable from yet another sinus infection that I put off too long getting looked at (in the vain hopes that I could avoid having to pay that 20% coinsurance as well as the copay...), and he sees that I  have a shit ton of swelling in my sinuses and my earsies.  He prescribes a corticosteroid nasal spray and an antibiotic.

The insurance apparently knows better than he does and says, "Nope.  Not that one.  This one".  And in the meantime, it is almost a week before I get my meds while they play their games.  Because insurance companies don't work on the weekends, or the holidays.  Didn't these germs get the memos?  Didn't my body learn to NOT get sick because that costs them money?  God, so selfish!

Yet nationalized medicine will make this  How is care not being rationed now?  How is this being effective?  Perhaps I would not have needed these meds if I had gone sooner.  Wait, that is my fault for expecting insurance, which is bought to cover these situations, to pay for medications.  Had I just gone sooner, I would not be in this dilemma.  Had I not been SO SELFISH and not worried about the cost, or saved more money to cover this situation while paying upwards of $3.65/gallon for gas and not getting pay increases because of the economy yet seeing insurance premiums almost double as well as the grocery bill skyrocket, along with gas and electric....

Or maybe if I had insurance that did not break the bank, if I knew that going to the doctor would not potentially lead to costly procedures that will bankrupt me....if I knew that going to the doctor when it was needed will not lead to the company being forced to go to a really crappy insurance like my work had to due to people ACTUALLY USING THE INSURANCE FOR WHAT IT IS FOR....maybe then this will not have happened.

Or maybe the insurance could just cover my meds so I feel better.

What do I pay them for again?

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