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Old Fri, Dec-06-19, 04:28
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WereBear WereBear is offline
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Posts: 14,731
 
Plan: EpiPaleo/Primal/LowOx
Stats: 220/130/150 Female 67
BF:
Progress: 129%
Location: USA
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Quote:
Originally Posted by Calianna
If he couldn't have tolerated the generics, or if they didn't lower his cholesterol "enough" , then they could put him on one of the newer brand name versions that supposedly causes fewer side effects, or are better at lowering cholesterol. There are also long acting statins, and statins combined with other CAD drugs. Those of course would be far more expensive.


DH is on Medicare and after a hellish year, the Advantage is finally working the way it is supposed to. We no longer get large and mysterious bills we're expected to pay. This might be a short-term situation because we're in open enrollment: not since the slave labor factories of the Third Reich has so much been demanded and so little given in return.

People think I exaggerate my loathing of health insurance companies. Well, these people are lucky: they've never come down with anything particularly expensive or poorly understood and thus, deniable.

I suspected a rare genetic disorder. This can't even be tested for in a lab, it's too complicated. It needs an expert diagnostician, so naturally my health insurance company doesn't have any in-network. Fair enough, so I asked for permission to find one. They encouraged me! They told me to do it!

In fact, they harassed me with thrice-weekly calls where they left no message and it was only an 800 number. So it was an ordeal to call them back and find out what they wanted, which was a chirpy, "We just wanted to know how you were doing!" "On the brink of death", was my answer. "Just like last time. Don't help me." But they kept doing it.

Finally I found a center with the specialization credentials required, four hours drive away. In my state of health, I would need a day off work and two nights in a motel because the evaluation took six hours. That's on me, that's okay, I did it.

I was right. I did have it. And they refused to pay the $2,000 bill. Because: "it's genetic, there's nothing that can be done." Well, there are things that can be done, but it's not drugs or surgery, so they chirpily informed me that I shouldn't have gotten it in the first place.

I was lucky in that my company has a Health Savings Account and I could use that to pay it. I could have filed an appeal with the state (at least my state has that) but the thought of more phone calls and paperwork when they had already pushed me into a worse state with their lack of help was too overwhelming.

I'm slowly getting better because at least now I know what was causing all my mysterious symptoms; the source of the stress that was triggering the auto-immune disorder; and what changes I needed to make in my life in order to have one, moving forward.

But it's no thanks to the "health" insurance companies. If any of you pray for health, you might as well add in the line, "please let my illness be recognized as one and paid for" because if you are an outlier in this game, they will let you dangle.
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