Name:
Location: Washington, United States

I began my TTC journey in January 2005. It finally worked with the 5th IUI and along came Eliana! I started trying for a second (T42) a little over a year later, and was thrilled to get pregnant on the second try this time. Jacob soon joined our family! Not sure if I am done at two, but come along for my journey in motherhood. If you stop by, please leave me a short note! I like to know when I have visitors. :)

Thursday, September 08, 2005

Breakdown

I had a mini-breakdown this evening. I received a phone call from the Hospital where I was supposed to have my appointment with the diabetes education people on Monday. They wanted me to call and be sure that my appointment would be covered by my insurance because they didn't think it would be. So, I called my HMO and the lady on the phone (with an absolutely annoyingly upbeat lilt-y voice) basically told me that it was unlikely that it would be covered (because they offer the same thing in Seattle) but that I could ask my Primary Care Physician (PCP) to put in a request for it to be covered which would take 3-5 days if marked "urgent/emergency" or 5-7 days if not.

Of course, this would just not do. The plan was for me to go to this appointment on Monday, incorporate what they tell me and then on Thursday I have the appointment with the OB where she will then decide whether or not to start me on insulin.

I called the lady back at the hospital, asked how much it would cost if I paid out of pocket ($650) and then I said I had to cancel the appointment.

I called my OB's office and left a message for them to call me back.

I got online and I emailed my PCP but really didn't even know what I wanted her to do.

It was at this point, that I decided to check that my diabetic test strips had been approved to send me more for my one month copay since I now am testing 6 times a day and the perinatologist was going to call. As I am looking at the pharmacy online, I see that it has not been changed, and worse yet, I start panicking because where it should say refills remaining, it says "OTC" and I have to pay full price for things that are over the counter....at about $85 a box and needing 3 boxes just for ONE month

By this point, I am getting rather hysterical. I frantically sent an email off to customer service (it is after 5 so there was no point calling again) asking if I now had to pay full price for my strips even though it says in my explanation of benefits book or whatever it is called that diabetic supplies are covered at the cost of a copay...I also emailed my PCP again this time to ask her about calling the pharmacy to a) increase my test strips each month and b) find out why I now had to pay full price.

Finally, the OB's office called back. As I am explaining the situation to the nurse, I can just feel and hear how I am panicking more every minute. She was very reassuring and told me that "this will just not do. You are pregnant" and that she would call my HMO tomorrow. Everything she said made sense. The whole reason it had never occured to me that it may not be covered is because when I asked about seeing this OB who is affiliated with my HMO but not at my HMO, they said it would be fine and everything OB/pregnancy related would be covered. Hopefully, the nurse is right and this should be covered and who knows, maybe she can reinstate my appointment on Monday.

I am calmer now. I am surprised that my doctor didn't respond to my email as she is usually very good at responding, and this time I felt like it was really important, much more than other emails that she has always responded to by the end of the day.

In other news, you haven't been hearing much from me because I am so exhausted with the beginning of school. I always find it so hard to readjust to getting up so darn early!

7 Comments:

Blogger NancyAlaska said...

One of my good friends - who is Type II diabetic (and overweight so she is high risk) is having her first baby tomorrow!!! She had a great, easy pregnancy. This was after many years of trying to get pregnant. I am very happy for her. I hope you have an easy pregnancy, too.

September 08, 2005 9:31 PM  
Blogger Mrs. G said...

Hey Kat,
I am keeping you in my prayers. I know how hard readjusting to early mornings is! I am a night owl myself. Well as far as the doctor thing goes,,,, hang in there! We will keep that in prayer, I know it is difficult dealing with insurance companies under "normal" circumstances, much less when you are really needing to get things done.
Hope school is going well and I hope you have a good weekend. Try not to let this HMO ruin your weekend. Get some rest and take care of yourself!

Hugs,
Gidgit

September 09, 2005 5:58 AM  
Blogger Jen said...

I'm sorry things aren't going well sweetie :( I'm sure it will all get better.

How's work going???? How are your students so far? and sheesh...How are YOU feeling??? Any morning sickness or anything???

September 09, 2005 9:45 PM  
Blogger carrie said...

Sorry to hear that you're having a rough time of things. I'm sure it'll all work out for you.

September 10, 2005 5:47 AM  
Blogger Care said...

Oh, insurance stuff is so frustrating! Hope you get it all straightened out. Isn't it awful how much those little strips cost? I never paid much attention until I my Grandmother got bad and I would go to the store for her and about fell over at how much they cost. {{Hugs}} ~CarolynG

September 10, 2005 5:24 PM  
Blogger Kenya said...

Sorry you went through so much with your hmo. I worked for an HMO and I know how frustrating things can sometimes get.

I was wondering the same things as Jen, how are your students this year and how are you?

Hope everything is better today and you're having a nice relaxing Sunday.

September 11, 2005 1:53 PM  
Blogger Katrina said...

Thanks everyone. Your support and prayers are always so appreciated.

I am going to write a new post with the full update. :)

September 11, 2005 5:29 PM  

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