Tuesday, August 01, 2017

How is this fair... or even right?

(Little preface here.... this may start off sounding like I'm talking about a female only problem or situation... but hang in there, because this turns into a bigger problem that is affecting a lot of people in our country right now... seriously.  I'm not trying to be cute or witty... so preface stated... HANG IN THERE for a few paragraphs)

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just HANG IN THERE!!! 

Last week, I talked about hormone replacement therapy.

& first, I wanted to thank everyone who gave me some insights on it through messages & comments. I love the way people can stay connected in this big world over big & small things.  We all need each other's help & thoughts in this world.  Or encouraging or helpful thoughts, I should say in this world of everyone has an opinion & feels free to voice the negative ones too. Luckily, that's not here in my blog world.

If you missed it, my doctor suggested I started on some cream that would boost up my estrogen levels... & I wasn't sure what I was going to do about it.  Do I start this stuff that has some risk to it?  Do I try& find natural supplements?  Do I just muddle through for a few years?

Well, I have to say, I won't be taking the cream.

Want to know why?  Because I hate my health insurance... that's why.

I called to get the price of the cream & found out it was $150.00 for a month's supply.

I asked them if that was with my health insurance.  Nope.  Whew!  Thank goodness.
So I gave them all of my insurance info & they told me to hang on... to which I hung on for 18 minutes & then said, FORGET THIS - I'll call back.  I hung up & went about life.

I called back the next day & asked what my total was going to be... $150.00.

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"Um, excuse me, but thats what they said yesterday. Did they check with my health insurance?"

...oh yeah.. .they sure enough did.

Do you know my health insurance covers ZERO of it. Zip. Nada. Zilch.  Big old goose egg.

I sat stunned & the pharmacist said, "Yeah, your insurance covers nothing that is compound made"


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I know my dog had bone cancer a few years ago & we had to get a compound medicine for her then. That medicine helped prolong her life too. She lasted about 4 months longer than expected because of the treatment we did for her.

& I thought, what if I needed that medicine for something worst than a hormone cream?

& I get it, if it was something life altering, I'd pay the $150.00 a month - grumbling - but that's not the point.

First, if it was a life saving medicine, I'm sure it would cost WAY more than $150.00 - but my medicine would still not cover anything on it.


Now, here's what irks me to the core.

It's not like I have a pitiful cheap policy.  I have talked about this before - but every time I do, my monthly deductibles go up... now, I'm paying $450.00 a month... for insurance that covers NOTHING.  Basically nothing.  At least we know it covers no compound medicine.

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& I work hard to earn money to pay $450.00 a month.....

& yet, I know personally a few people that are getting government assistance & get health insurance that covers every single little iota of doctors visits, every test, every medication they want.

& this is not a slam to them. At all...

I know there are some people that need that assistance & it helps them in ways they wouldn't be able to get the help they need otherwise... but I'm also not naive to the fact that there are people that take advantage of it, which is so bothersome to me as someone to works so hard to pay for coverage myself & then this is reward you get for not being a burden on our government or tax payers....

But what this is a slam to is to the insurance companies that are keeping this ridiculousness up.
To the government that lets this sort of treatment to hard working American citizens continue.

This is a slam to my pocket, is what its a slam too.

How is this fair... or even right?

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I was so mad when I hung up the phone & said, "OK God, I wasn't sure whether to take this medicine or not.... this is my answer"... & that actually calmed me down for this incident.

& I prayed that my health stays up so I dont have to deal with bigger or stronger medicines that could cost me everything I own, just to stay alive.

Something has to be done... I dont know what...

I dont get on a soap box for much in this world when it comes to government or politics - but I think its because most things, when they dont touch us in a personal way, we are great at ignoring it.

I cant ignore this. Every year, it gets worse & worse. My rates go up, my coverage is less.  & as I posted a few weeks ago, I may not even HAVE a policy to choose from come 2018 when our only provider for Indiana (Anthem) pulls out of our state... & then what do I do?

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It's just so frustrating... & irritating...& makes my blood pressure raise through the roof.

& I actually contacted my state Senator & told them my situation.  & I am a skeptical person most of the time & feel like it's in a pile of a thousand other complaints that probably make it to the shredder bin at 5:00 pm each day... but at least I did something that I hope makes a difference. Voiced my opinion.

Same thing I'm doing here.

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Because I know there are people who are battling for their lives that are going through the situation where they have to decide if they want to live, or if they want a roof over their head.  If they want to live, or have food in their cabinets.  If they want to live, or if they want electricity in their home.

How is this fair... or even right?

Luckily,for me & my situation, mine is just a hormone cream that I dont need....

I'm looking into alternative & natural supplements.  More my style anyways.

I'm getting off my soap box....

& for the record, I started my period when I got off the phone with the pharmacist. So take your hormone cream & shove it....

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  1. It's not right and it's not fair! I pay about $700 for my insurance (hubby's work pays for his) and it still doesn't cover everything. Some of our prescriptions are free, some cost a small co-pay (but even our co-pay varies), and some it refuses to cover...basically those the insurance company has deemed unnecessary to quality of life, I guess. Or if they think it's just cosmetic...like the medicine to clear up toenail fungus (It won't kill you, it's just ugly) or a prescription hair removal cream my gyno prescribed (I'll just keep plucking, thanks). The one that ticks me off the most is that our insurance covers a sleep study completely, but will only pay for half the cost of renting the CPAP equipment. What the heck?? I will be one happy camper if/when the clowns in Washington quit arguing and worrying more about their party "winning" and start doing something to benefit us poor saps that voted for them.

  2. Wow - I know some people who just go ahead and skip out on health insurance and pay the fine with their taxes. Sure, they're taking a gamble that they won't get sick or injured but the penalty is less than what they'd be paying for insurance during the year. You're right though - it's not fair. Will you be able to transfer to doctors in Kentucky? I mean, you shouldn't have to and I can't believe one of the largest insurers will drop an entire state ... but there's gotta be some sort of alternative that'll work.

    On the natural remedies -- I wish I knew of something that will help you. But ... hang in there!!

  3. We pay about $650 for our combined insurance. K works for himself and I work for him, so we have no other option but private ins. It's a silver plan but it's total crap. It covers like one visit annually and no dental or eye stuff. And we still get medical bills every single time we go to the dr.
    I'm grateful that we can afford our ins. (although bitter that it's half my effing mortgage with nothing to show for it), but I worry so much about others who can't. What if their kids get sick or injured? Cancer doesn't discriminate as far as wages or economic status go. It's a pretty broken system. (That said, I don't believe that the trash in DC is on the path to making it any better. I honestly don't know the answer. Or I don't care to voice it at the risk of being called a socialist.)

  4. I cannot imagine paying so much for health insurance - my dad has type 2 diabetes & his premiums are through the roof as well. I take for granted the $60 some that I pay through my employer... which is a healthcare industry & health insurance.

    This is my last week working for their health insurance side & I'll be heading over to their health care side of the business.

    Even though I have worked in health insurance for the past 3.5 years, I do NOT agree with what goes down. I have worked for the Appeals Department for 2.5 years... reading all about how people are so sick & our doctors decide something is not medically necessary & the insurance won't cover it. I do not understand why our doctors have so much control when they haven't even seen the patient.

    I'm so sorry you've had to go through this! - but I'm glad it's for something that you don't need to save your life.

    What can we do? I wish I felt like things with healthcare were going to change in the future..

  5. You're really speaking to the deeper issue with ACA. It is on a different level than Medicare and Medicaid and I know so many businesses who couldn't believe, or figure out a way, to do what the last administration wanted them to do when it came to paying for employees' healthcare.
    I know a lot of people want us to function the way many other countries do when it comes to healthcare but I don't think anyone realizes (knowingly) just how HIGH taxes on food, clothes, etc would have to be in order for that to happen. Plus, the wait lists for treatment because it's not based on who can pay and who can't. The differences between private hospitals and public hospitals, etc.
    My school's insurance is terrible and expensive. The military insurance is "free" but it covers just the basics. I wait weeks/months for referrals and then those costs are on me.

    A frustrating situation indeed. I'll be thinking of you and hoping you start to improve on your own!

  6. I work in the healthcare industry and all I can say is Welcome to Obama Care! It's the government and pharmaceutical companies that are the culprits. Kudos for contacting your legislators! I'm interested in reading about what other options you decide to go with and I agree that this may be an answer to your prayers.

  7. Ugh, I'm sorry to hear you're going through this :( I hope you find some other solutions that can help out instead of the medicine. I have several medicines I have to take for long term health problems and my doctor wants to put me on one more and the cost is one of the reasons I'm trying to avoid it. I'm hoping I can find some natural remedies that will work instead but we''ll see.

  8. I 100% resonate with you on the cost of medical care/medical drugs/medical needs. It is SOOO expensive, and I personally think that it is way more inflated than it needs to be.

  9. When you said it was a compound I almost warned you that it would probably be expensive & not covered. I had the same situation for derm medication & it was YEARS ago, so I know it hasn't gotten any better. Recently my doctor prescribed something to help me lose weight before my surgery. Even after my insurance took $200 off the price, it was going to cost over $1,000 for a month. Um, no thank you!

    I have good insurance through my company, but it's a high deductible plan, so I'll end up paying over $7,000 for my surgery & related tests/appointments/procedures. In hindsight I should have paid for the more expensive plan with a low deductible. Ah well, sadly in the country, health insurance is a gambling game.

  10. My insurance is crap too and I pay out the ass every month for it. Some places don't even freaking take it. That tells you how crappy it is. You don't even want to know how much my bill was from having a c section and the care for Zoe and I in the hospital for the three days we were there. I am making monthly payments on it for the indefinite future. That is all I am going to say about that. The healthcare situation in this country is a disgrace.

  11. I have the Indiana marketplace insurance - Caresource. It still doesn't cover very much, but at least I only pay $108 a month. So, there's that. :/ I agree, something needs to be done about premiums and decent coverage.

  12. I just don't understand how we can have such problems with healthcare here. It just doesn't make sense to me, ya know? We should be the leaders! It's insanity. I wish I had the answers for both healthcare and your estrogen levels but I don't. You live in Kentucky, right? Mitch McConnell's state? Maybe leave him a little VM that healthcare is a universal concern that affects every single American, regardless of their political affiliation, and to stop trying to "fix" healthcare in secret but do it openly so the bill can both pass and be decent.

  13. NOT right at all!! Ugh don't even get started about the people who take advantage. My Canadian friends have amazing healthcare, lets move there, lol. It sucks, just plan sucks here.

  14. The system is not right and so unfair. I'm sorry you are going through all of this. My company offers health insurance that is through the roof. Thankfully my husband has great insurance and we are all covered under him but if it wasn't for that I don't know what we would do. I don't know why other countries can get it together and we can't. Oh wait, I have to go with it's all a money making scheme :/
    Beautifully Candid

  15. A friend of mine has Type 1 diabetes and he posted on FB an AMAZING video ranting about the cost of his medication. His necessary to sustain life medication. It absolute bullshit what insurance companies and the pharmaceutical industry do and get away with and although my healthcare situation is quite different from yours, I am outraged on your behalf. Because it is ridiculous.

  16. I expected by prescriptions to be a lot less on Medicare. Ha! It took me only five months to hit the "donut hole" and now one of my meds is $150.00 a month. It is one that I can't do without. I found a Canadian pharmacy where I can get it for $99.00 a month. Even that is bad enough, but at least it is $50 less. Crazy. Perhaps it will all change for the better soon, if we can get the ACA repealed and stop the nonsense. It has hurt us all.

  17. OMG I can see where this would be so frustrating for sure! It's definitely not right what the insurance is doing but hopefully this is not a roadblock but just a detour. Hopefully this is God's way of showing you there is a better alternative out there for you, (hopefully). Hey I'm just trying to see the glass half full!

  18. Oh my lady! Yes. I have to say, as someone who worked in a Headstart preschool with low income kiddos for several years. The health insurance business is all kinds of messed up. Like you said, some people are able to benefit from assistance, some take advantage, but everytime it comes up, I think of those kiddos, and I want them to have what they need related to their health with all my heart. So I hope that they can get assistance, and I hope that their parents are responsible. Because they deserve to be healthy and safe, even if their parents are making bad decisions. You know? :( It's just so tough, the whole thing. I'm lucky that I haven't had a lot of health issues, and that if I do, I've been able to pay them off out of pocket so far. But boy is it expensive. And I know a lot of people who are not able to get what they need. And the political side of this is indeed a mess too. I just can't understand it. Let's have Americans be healthy!! Good Lord. Don't buddy up with insurance companies to turn a profit on other people's money and health issues!! We are lucky to have pretty good insurance where we work, but it still changes and gets more expensive each year as well. I hope that someday we can get it together. Hugs. XO - Alexandra

    Simply Alexandra: My Favorite Things

  19. This is what pisses me off. Instead of improving the ACA and making it work as it was intended in phase two, battling big pharma on the cost of medications and battling insurance companies on the costs of premiums vs. what they cover, Congress has BS'd around for the past now nine years attempting to repeal the ACA with no backup plan. NO. Sorry, no.

    Other countries can figure this out. Why can't we? It is a DISGRACE to pay $450/month and then an additional $150 for something you NEED to be healthy.

  20. This is so frustrating. Matt has Type 1 diabetes, and pays a lot of money each month towards his health insurance, and the amount we still pay out of pocket is insane. Thousands and thousands of dollars each year, for medicine that he would die without. Crazy.


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