insurance/kidney rant-Updated 1-6-11

Kim, I'm really sorry to hear this. I hate all the red tape that people have to
go through in this country too.

I hope that you get this taken care of quickly, get the kidney you need
finally and lead a somewhat normal life.

I don't know if you believe in prayer, but I'll say a big one tonight before
I turn in.

Yeah, it makes sense that they took you off the list for cancer, and waited two years. But can't they PROVISIONALLY put you on the list? The sooner you go on, the higher your priority will be. I hate to say it but, at your age, you may get knocked down the list ANYWAY. So what kind of testing do they need? I mean you ALREADY passed the basic health requirements, clearing for cancer, and had tissue typing, so what else is there? I mean all the stuff I listed, in your case, would be REQUIRED before they even CONSIDERED putting you on the list. They don't just say OH, you need a kidney, you get on the list.

Steve

Steven, yes I do and thank you for your thoughts.

Steve, I will be getting a letter in the mail in the next day or two I believe listing the aditional tests I need to take, but from what I understand one is another blood workup ( which has been done several times ) and another is a "doppler" of my veins,which I don't have a clue about. I know a few months back they did a "doppler" of the veins in my throat,I believe they are called cartoid veins? which showed some blockage but from what I understand it was normal for someone my age.

Kim,
Makes ya wanna rip someone a new one...the idjuts

you said:
From what I was told, I had already been cleared by the insurance company but they now have a new transplant case manager and even though the old case manager has cleared me, I now have to do this new battery.

I would think it should have more to do with your records than changing personnel :/
think I'd be asking a superior why the new case manager cannot reference and comprehend previous case manager's records???

(just helping you rant)
:-)
wish I had sound advice that might help....but sadly, we have put ourselves at the mercy of the companies and the red tape.

hugs
Andie

Sorry for all the red tape and bureaucratic bs you have to go through Kim. I can certainly understand why health insurance is so expensive.

Like you really need this added stress on top of everything else you've had to endure.

Keep your chin up - there will be better days ahead.

I am almost always upbeat I think. At least I try to be. I get up every day feeling I am watched over. While I do have sick days, I have more healthy ones than sick. And I look healthier than those that get their treatments in center. The biggest hurdle I face every day is the dialysis. While I am only on the machine about two hours for treatment, there is before and after prep time that adds anouther hour to hour and a half to the whole procedure. But in the big scheme of things, I'm doing ok.

Kim, you had good reason for this little rant! The public needs to be aware of this.

As for your attitude, you are always upbeat. Keeping that frame of mind will serve you well during your recovery - now, just gotta find ya that kidney.

Outrageous Kim.

What else can I say - Ridiculous.

I know you will always endure and overcome and you have already had a lot of practice.

"And don't insurance companies pay for the tests? You would think they would save a few hundred dollars and just accept older tests."

I agree Steve. That's one thing that makes Gordon's theory very believable.

"I'm not sure exactly when we passed the barrier where your treatment is determined by your doctor - insurance took over some time ago and that's just sad."

You are absolutely right. We as a country need to take that right back.
Of course, we now let the pharmacutical companies diagnose and prescribe to us over the TV.
When I was growing up the Drs did make the decisions. NOt insurance companies. The insurance companies should do what they were created to do.

Updated:

I just received a call from the case manager and between the hospital and the insurance company they have decided that I do not need to do any more tests at this time after all.
The insurance company has approved my case and I should now officially be back on the transplant list!

Kimw,

I was denied drugs, even drugs I NEEDED, because the INSURANCE didn't want to pay! They didn't TELL me that. They simply said "We can't fill that yet.". I thought, originally, that it was due to the prescription. It WASN'T! After I found that out, I paid for prescriptions about 3 times IN FULL to get what I needed WHEN I needed it.

That's ANOTHER thing! Doctors and hospitals generally won't even ATTEMPT to quote how much a given procedure will cost! AND, if you DARE to ask what MEDICINE costs, they will tell you your copay, or ask "WHY? Doesn't INSURANCE pay for it?". Yet OTHER reasons why insurance is so high and why the insurance companies hire people to try to limit such thinking.

Oh, and ROSCHE finally did what I have been expecting for a few years! They, at the last minute, said that their perishible supplies will NOT be replaced! My $2000 meter is now relegated to basically being a piece of junk. To merely REPLACE this NEEDED device, I need ANOTHER prescription! The joke is on them though. I will NOT be getting their new device, which they are trying to trick the world into getting. I'm going to by a competitive device that has an established track record from ANOTHER supplier. Even the SUPPLIES cost less, but the new machine costs $1500, instead of the $2500 their supplier wanted!

It is ASTOUNDING what the FTC and FDA allow sometimes. The device in question IS subject to FDA and FTC rules.

Steve

Wow that sucks about the cancerr and all.

I had one 12 years ago.

Of course being in Canada the insurance is a non issue.

Glad the insurance company saw it your way!

Best of luck.

Kim!
Yipeeee --nice to know they are not all simply mindless idiots

Glad they sorted it out and you have less to suffer through!
Andie

great information.. thanks for posting..

Kim,
I sent you a pm

I don't know if it is possible but if it is I am real about it

Cheers
-Will

Kim -
c'mon...post a pic of you doing your Happy Snoopy Dance!!

mega-happy for you

A

Your gonna be sorry you said that!

LOL I love it!!
Poor Snoop .... I was probably the only (socalled) grownup that watched the charlie brown holiday shows without kids around..

Agreed Steve!

Okay - now that is more like it. Like you said - it should be doctors giving orders on treatments, not corporations. Insurance companies know the risks of their field. If they think too many people are getting sick for them to afford it, maybe they should take on the FDA and Gov and anyone else who allows toxic waste to be spewed all over the planet and dumped in our foods - and maybe make drugs less dangerous, too. No - that would make sense. It's much easier to just make people pay for services they can't get.
<end of my rant>

Kim - as slick has you have become at beating odds - I think that we're going to be putting up with your cranky *ss for many long years to come.