Run Around

(At the request of my husband - names of specific insurance companies have been omitted.)

Dear Insurance A,

I'm sorry my son needs so much.  I'm sorry you got stuck being our "primary" health insurance.  If you could please stop sending us those "coordination of benefits" forms for us to fill out - that would be a help.  Ray is older than me.  Next year, guess what?  He will still be older than me - thus... you will still be primary.  Funny.... age sort of works like that.  I realize you would really like to pass the buck on this one.... but - you are costing me man hours that I don't have.
So, you've basically denied almost everything we've submitted to you.  That's awesome, by the way.  You know I pay into my health insurance every month... right?  Again... sorry you got the short end of the stick.  You got stuck having to actually pay out rather than just collect.  

You denied our nursing hours, almost all of our extra medical needs, and here is the kicker... you just denied Alexander's stander.  Yup.  You don't think it is medically necessary for him.  Just a quick question - what criteria exactly do use to determine medically necessary?  Really? What is it about Alexander that makes you think he doesn't deserve a stander? 

Total hours on the phone with Insurance A for this one issue = 6 and counting.  We are in our second appeal.  Seriously... You've seen pictures.  How is it that he doesn't need the stander?

Dear Insurance B,
I'm so glad that I have you as my health insurance.  Seriously, you should be thrilled... you are the secondary.  Insurance A has to first deny us.  Oh, what is that?  You defer to what Insurance A says?  How convenient for us all.  So basically, if Insurance A approves our claim (and coincidentally pays for it), then you will approve it also... hmm - that costs you $0.00, right?  Or if Insurance A denies our claim (and decides not to pay), then you will deny also... hmm - that costs you $0.00 also, right?  How nice for you.  You do remember that I diligently pay my health insurance premium every month, right?  I mean... we are "teachers" - we get the best medical coverage there is.

Dear Medical Assistance,
Is it any wonder you get a bad rap?  You seem to be the only one who will approve us for anything.  Thank you for the nursing hours.  Thank you for approving the stander.  But it shouldn't be this way.  No wonder the tax payers are so upset.  You are the only one who seems to understand that Alexander has potential and should get some extra help. 

I'm trying to be totally honest here about our situation so you can really get an idea.  Ray and I should be on top of the world.  We are both teachers - so you know we have great health insurance.  Ray's is primary - Insurance A and mine is secondary - Insurance B. Then Alexander is also covered by medical assistance.

You know what we are?  Their worst nightmare.

I think a lot of families with extenuating circumstances are frustrated.  I read about this frustration all the time.  The problem is, most people have a really difficult time expressing these thoughts without sounding bitter.  And, maybe I sound bitter too.  I'm not.  A little frustrated.  It seems we are always on the phone with someone about some services.  Probably 3 hours total just yesterday... just getting the run around on this stinking stander.  Appeal after Appeal.  The truth is, my son will have the stander - and I'm not bitter - but I'm not a quitter either.  The insurance companies want to outlast you.  They hope you will give up before they give in.

If you've never been in this situation before - congrats.  If you end up in this situation - don't give up.  And ... if you are already traveling this path - we are right there with you. Out last them. You can do it!