Don't get me wrong, I love my insurance company - except for a few little details. They seem to treat asthma as a one size fits all disease, which of course it's not.
Their medical board has decided to no longer cover Xopenex (levalbuterol). It's more expensive than Albuterol, so of course they want everyone to use the cheaper version.
Son #2 (severe asthmatic) is sick again. Asthma Doctor was out of the office, so we went to the Pediatrician. He sort of squinted his eyes at Son #2 and said, "I know how he is, we better start him on Prednisone." I looked at our medical file in his hands, it must have been close to 3 inches thick! He's on to us....
He knows he has to be agressive in treating Son #2. The only problem is his Xopenex inhaler and nebulizer vials have just expired. And insurance is no longer covering them. Pediatrician suggested I call the pharmacies and ask for the cash price. A Xopenex inhaler will be $58, the vials for the nebulizer will run $130.
So, now what? They can write a letter to the insurance company and ask them to reconsider and cover this medication for Son #2, since Albuterol is not effective on him. But where do I come up with $188? I also need to get the Prednisone prescription filled, luckily that's cheap. Add to that a Z-pack prescription. (Plus $25 for the Pediatrician visit) I also need a refill on my Advair disc, as does Kitty for her Advair.
And I wonder where all my money goes?!
At least insurance is still covering his Xolair prescriptions - it used to be $1000 a month, but that's what it was when Son #2 started receiving injections almost 3 years ago, I'm sure the price has gone up since then.
Anyone else have fun with their insurance company? And what do you do? I think I'll take a deep breath and hand over my debit card from my flex plan. (We set aside thousands of pre tax dollars every year from insurance to pay for co-pays and presciptions). But we always end up using the money before our year is up. We usually spend it all in 4 or 5 months.
But, as I always tell the kids, "things can always be worse"! We'll figure it out. Even if we have to cut back on the grocery budget and eat 'creatively' until the next paycheck.
Well, time to finish last minute preparations for Halloween. And of course tomorrow night I'll be checking Son #2's candy, to make sure he didn't get anything with tree nuts in it. Fun times!