It has been a stressful week here at the Casa de Fali. My husband has been working 16 hour days, and both of us are playing a large part in the organization and execution of a charity event which stretches through this upcoming weekend. On top of that our kids are being shipped off, to two different locations on Friday and Saturday too. That alone takes a whole lot of planning. If they aren’t on my list, I’ll likely forget to pack one of them.
But the reason I am exceptionally on edge right now is because of a nightmare of epic proportions. A bad dream full of red-tape, labeled with words like “effective dates”, “claim forms”, and “benefits”. And let me tell you, they don’t put that little skull and crossbones on Rx bottles for nothing.
Now I am not one to complain too much about health insurance. I had two premature babies, and have a son who has had nine surgeries and lots of hospitalizations. My daughter’s bill from her stint in the NICU was $135,000. Not one to be outdone…my son’s combination of services has put him well over that figure.
We will never put into health insurance what we have taken out.
That may not give me any right to complain, but it also puts me in a position where I know a lot of the ins and outs of the industry. And it is one messed up industry.
February has put our family in a sort of insurance limbo, and we are not a group of people who can afford to be in that situation. We have been somewhere between COBRA benefits through my husband’s former employer and having an exception made to our effective date with his new one.
While all this has been up in the air we have continued to need prescriptions. My son desperately needs his reflux medication, he and I both take something for asthma, and my daughter came down with strep throat. In the past two weeks, we have paid our pharmacy nearly $700.00, fully expecting to be reimbursed.
We were, in the sense that yesterday nearly half of that was applied to the deductible on our new plan. But the reflux medicine my son desperately needs? The one that he has to have in order to not throw up every day? The one that costs $388.00 a month? It’s not covered at all.
Not only are we out that money, but now we get to go playing around with G.I. medications until we find something that works comparably well. The cocktail he’s on now took over a year, and a LOT of screaming (by both of us) to come up with…and now we throw that recipe right out the window and start over.
That is why our system is flawed. This kid is six years old and doesn’t deserve to be in pain, or vomit every day when there is something out there that will stop it from happening. His parents shouldn’t have to go bankrupt to provide it for him either.
So if you don’t know where to find me, just look for the mom banging her head against the wall. Though I won’t bang it hard enough that I’ll need to use my health insurance. You can be sure of that.