having a bad day---another insurance dilema

Moesimo
Moesimo Member Posts: 1,072 Member
edited March 2014 in Colorectal Cancer #1
Hi to all:

I just had a good cry, my first in months. I have a colostomy and want to learn to irrigate. I have an appt. to have the stoma nurse help me in May. I have been ordering supplies to be ready for the big day. I ordered an irrigating kit in Jan. Now I want to order another to have a spare. The company that I get my supplies from told me that an irrigating kit is no longer covered. They sent me a substitution which looks like a hot water bottle, without tubing. I have HMO Blue and haven't had to pay for anything yet, esp. ostomy supplies. I have contacted another supplier and they are checking to see if the irrigating eqip. is covered. When I called blue cross they said I have UNLIMITED coverage, but the supplier says it exceeds the cost. Catch 22---huh. Tomorrow I will call the stoma nurse to see if anyone else is having difficulty. I will let you know what happens. I am just venting.

Maureen

Comments

  • CAMaura
    CAMaura Member Posts: 719 Member
    #2
    Hey Maureen - I am so sorry that you are experiencing any of this hassle.
    My first thought was: Ya know... you aren't trying to do anything but take care of yourself - HELLO! This is like a 'no brainer'...but hey, I think we have all been then in one way or another.
    I received chemo at my onc's office (an infusion center inthe back of the offices - sounds creepy but was quite high-end). I had called my insurance company before chemo started to figure out what was and was not covered. I was told that everything - EVERYTHING - was covered - excepting my doc-office visits. Well, I started receiveing bills for each time I crossed the threshhold to this place - chemo start, chemo un-plug from the pump, any IV fluids given - ...and we ain't talkin' a honeymoon. When I pressed - and went to visit the accountant - her reply was: We charge you because we can. Wow...I was floored - worse than any insurance backlash.
    Needless to say, I was relentless and paid for only the doc appts, but I really feel for you. This is something where maybe one of the colon cancer societies/clubs, etc. might be able to help; or possible bringing this to the medical group board for review. Again, you are just trying to get your ducks in row....a good thing.
    Take care, and vent again...maybe some of us will be able to brainstorm with you for a solution.
    Wishing you the best - Maura
  • spongebob
    spongebob Member Posts: 2,565 Member
    #3
    CAMaura said:

    Hey Maureen - I am so sorry that you are experiencing any of this hassle.
    My first thought was: Ya know... you aren't trying to do anything but take care of yourself - HELLO! This is like a 'no brainer'...but hey, I think we have all been then in one way or another.
    I received chemo at my onc's office (an infusion center inthe back of the offices - sounds creepy but was quite high-end). I had called my insurance company before chemo started to figure out what was and was not covered. I was told that everything - EVERYTHING - was covered - excepting my doc-office visits. Well, I started receiveing bills for each time I crossed the threshhold to this place - chemo start, chemo un-plug from the pump, any IV fluids given - ...and we ain't talkin' a honeymoon. When I pressed - and went to visit the accountant - her reply was: We charge you because we can. Wow...I was floored - worse than any insurance backlash.
    Needless to say, I was relentless and paid for only the doc appts, but I really feel for you. This is something where maybe one of the colon cancer societies/clubs, etc. might be able to help; or possible bringing this to the medical group board for review. Again, you are just trying to get your ducks in row....a good thing.
    Take care, and vent again...maybe some of us will be able to brainstorm with you for a solution.
    Wishing you the best - Maura

    Maureen -

    You vent away, Darlin'

    That's what we're here for - and maybe someone here can pass along some info that will assist you or maybe they can help in some other way - you never know.

    Keeping you in my prayers.

    - SpongeBob
  • KathiM
    KathiM Member Posts: 8,028 Member
    #4
    Maureen,
    Did you see my post....I'm feeling for ya, gal!
    What I did (I DID get my treatment yesterday) is call the insurance company, get a name and number for your supplier to call (I was buddy-buddy with my ins gal...said "you know, I will go after onc to medical board....just KNOW it CAN'T be YOU GUYS!!!)". preped THEM for fact that I WILL seek legal action. THEN went to supplier and was buddy-buddy, told them Sue was waiting for there call, etc, reversed that I KNEW it COULDN'T be THEM (getting the picture).
    I HATE the fact that WE PATIENTS have to do this. As in my post, I'm fighting for my life...and in your case also QUALITY of life, SHAME ON ALL OF THEM!!!!!
    Kathi
  • kangatoo
    kangatoo Member Posts: 2,105 Member
    #5
    KathiM said:

    Maureen,
    Did you see my post....I'm feeling for ya, gal!
    What I did (I DID get my treatment yesterday) is call the insurance company, get a name and number for your supplier to call (I was buddy-buddy with my ins gal...said "you know, I will go after onc to medical board....just KNOW it CAN'T be YOU GUYS!!!)". preped THEM for fact that I WILL seek legal action. THEN went to supplier and was buddy-buddy, told them Sue was waiting for there call, etc, reversed that I KNEW it COULDN'T be THEM (getting the picture).
    I HATE the fact that WE PATIENTS have to do this. As in my post, I'm fighting for my life...and in your case also QUALITY of life, SHAME ON ALL OF THEM!!!!!
    Kathi

    Hi Maureen.....I just posted a while back my views on insurance companies so won't reiterate here. Just wanted to lend a shoulder gal. It really horrifies me how the sick are treated.
    Shame, shame, shame!We hope you are able to sort this out in your favour Moe....lotsa luv, Ross n Jen
  • markatger
    markatger Member Posts: 314
    #6
    Ugh Maureen...

    @** insurance companies. So sorry to hear about your problems.

    I would suggest again going to an ostomy support site. Someone there may have knowledge or ideas about how to get the kits you want at low cost.

    Hope it works out soon.

    Maria
  • taunya
    taunya Member Posts: 390 Member
    #7
    Wow Maureen, that just stinks! I really am sorry to hear that you are having to deal with that (not surprised though). The insurance companies seem to forget that they are not giving handouts, we PAY for the services. I hope this gets straightened out for you quickly. Vent all you want. We got your back!
    Love,
    Taunya

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