Battling insurance companies

 

 

 

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 sick your son gets with asthma, we better start him on Prednisone." 

 

I looked at our family's medical file in the doctor's hands, it was shocked to see it was about 3"  thick! 

 

He's on to us....

He knows he has to be aggressive in treating Son #2. The only problem is my son's 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) Kitty and I also need to refill our Advair discs.

And I wonder where all my money goes?!

At least insurance is still covering his Xolair injections - it used to be $1000 a month when he started on it 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 prescriptions). But we always end up using the money before our year is up. We usually spend a year's worth ofd money 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. 

 

Allergies, food allergies and asthma, always fun times!