Monday, November 10, 2008

One of those days

My struggle with insurance companies will forever be a never-ending battle now that I have this disability. Today was "one of those days." First, my insurance is horrible. There are different tiers of coverage depending if you meet that monetary deductible. I've worked all year to finally get to the point of receiving 90% coverage. The sad part is that in January, it all starts over and I go back down to 0% coverage. Well, here's where the battle begins.

I am in need of a new wheelchair. My current wheelchair is falling apart, and quite blatantly, I hate it. I would not recommend it to anyone. In September, I flew back to Atlanta and my favorite people at Shepherd Center evaluate me for a new wheelchair and write up a prescription. They found a local vendor in Georgia who said they were listed as a provider and were going to get my wheelchair for me. Well, they took their sweet time submitting the Pre-Authorization to insurance, and after a month and a half of wasting my time, it turns out they are not a provider under my insurance. That now leaves me with trying to find a local vendor here in California to fill this order. The problem with that is that vendor's here want to do their own evaluation, have to submit their own Pre-Auth to my insurance company, and then they can place the order. Well, there are only 6 weeks left in the year before my insurance goes back to 0% coverage. This means, they have to scramble to try to get everything set to go for it to get back here in 6 weeks. Bottom line? It's not going to happen. This means, I'm forced to pay about $10,000 for a wheelchair.... out of pocket. This is money I obviously don't have, but it's a medical device I have to have.

What do insurance companies think people with disabilities are supposed to do??? We need these medical devices, however they cost a fortune to purchase! I'm so frustrated and feel so helpless. Even people in the medical industry don't really seem to be on my side. These days, it's all about the money. I guess I'll just crawl to work since the wheelchair I use might not get me there. I swear. America might be becoming a third world country after all if I have to start crawling to work.

2 comments:

Marci said...

Insurance is frustrating! My sisters have insurance coverage for their glasses so that they can see better, but if I were to get the hearing aids I need so that I can hear better . . . I'd be paying for them out of pocket. Needless to say, world, you're just going to have to speak up! : )

Julie Tiemann said...

I'm so sorry, Alyson... I totally understand the insurance hassle (though obviously not your specific instance) b/c of all we've gone through since having Amelia. I groan every time I get an EOB...