Borrowed from Amy T's DiabetesMine.com

Old-n-Grey-n-Wiser
By Old-n-Grey-n-Wiser Latest Reply 2012-04-15 16:36:51 -0500
Started 2012-04-13 12:21:01 -0500

My Flex Spending Fiasco
by
AmyT on April 11, 2012
We all spend too much time fighting insurance coverage battles, am I right? This humongous time-sink can be one of the worst things about living with a chronic illness. But don’t take my word for it. Take a read on fellow D-blogger and journalist Mike Hoskins’ latest row:
Special to the ‘Mine by Mike Hoskins
Like most of you, we spend thousands of dollars in diabetes supplies and meds every year.
Thankfully, our insurance coverage provides a Flex Spending Account (FSA) to help us not have to eat through this money on the front end. It’s a simple concept: money you earn goes into a pot to be used during the course of a year to pay for certain medical supplies. Submit receipts to prove that all is legit, and personal money spent is reimbursed forthwith.
At least, that’s how it should work.

Read the full article at http://www.diabetesmine.com/2012/04/my-flex-s...


9 replies

Gabby
GabbyPA 2012-04-14 11:30:07 -0500 Report

Amy is great and if you guys don't visit her site, you really should. www.diabetesmine.com Her wit in writing her blogs is wonderful. Even if the topic is horrific.

Yes, this is what we will have more and more of. Get ready. If the supreme court doesn't find the Health Care law unconstitutional or at least the mandate, there will be so much more of this to come.

I was watching the news the other day where there is a huge shortage of many pharmaceuticals that are needed in the ER or regime treatment for cancers that doctors have been loosing the battle of saving lives. The drug companies will drop production of less profitable drugs and if generics are not picking up on them, they fall short. It is all quite frightening. And we have just seen the tip of the iceberg.

pixsidust
pixsidust 2012-04-13 23:53:28 -0500 Report

Oh My God You are in Hell!
Hell here on earth!
I can't stand it!
Call the media, we have a you paid for it here in St Louis
Surely you have something there!
Let them be uncovered.
Insurance companies hate media coverage and usually bend so they
do not look like the demons they are!

red flower lady
red flower lady 2012-04-13 23:29:41 -0500 Report

I also have had similar situation. I finally sent a registered letter, so as to have a date and signature for proof to keep the money from vanishing! I had them send me a detailed letter of what they needed in order to accept the claims, then I added a copy of it with the required new info that I highlited in different colors(checked off) to show that it matched what they asked for. Just helping the incompetent who is going to tell me that it doesn't. So, naturally when it didn't work I knew how the next call would go. I informed them that just like they record the calls, and I thanked them for that, I also had dates, time calls started and ended (cell phone records as proof as well), and with whom I spoke with and the discussion. I also reminded them that in each conversation I said yes that the calls can be recorded by both of us and none of their people refused it and feel free to verify it, this left them speechless a few seconds. Oh, I didn't actually record it, but then I didn't say I did! Then I informed them that my next step would either be getting an attorney(law suit) or a call to my local tv station, but probably both so as to please myself for all the mental anguish they provided me with which is not good for my medical conditions. I thanked the person for once again not helping me and hung up. Yes, I did work my way up the chain without luck on all the calls.

It was funny how 20 minutes later I got a call from a "senior manager" telling me that they were working on my account and it would be accredited before close of the day. I asked for that in writing and fax it to me while I waited for them to complete the work. Once the account was complete and they faxed that to me as well, I faxed a letter back to them letting them know that if I had this problem again, I would bypass the endless calls/letters and go straight to my last two options. I have to admit that I didn't have any more problems. It is insane to have to ever go to this extent for something that you have the right to use.

Type1Lou
Type1Lou 2012-04-14 11:09:55 -0500 Report

Bravo RFL! Yes, we need to make these companies accountable for their actions (or inactions). Keeping records of whom we talk to and when, every time we call them is a wise practice…that way, we have the data we need to document our actions "ab initio" (from the beginning), if we need to pursue the issue. Just goes to show how the squeaky wheel does get the grease!.

red flower lady
red flower lady 2012-04-15 16:36:51 -0500 Report

It is such a pitty that we even have to do this. Why does it always seem like pulling teeth to get what we are entitled to? I remember when it used to be easy. I'm usually very easy to get along with until something like that happens.

Type1Lou
Type1Lou 2012-04-13 15:02:31 -0500 Report

Dear Tom,
Having fought a slightly similar battle with Medco, I can wholly commiserate with the battle described in your discussion. (More details in my discussion from last year "Medco makes my blood boil!") Here's what worked for me. After Medco shorted me 1 bottle of insulin by sending me 2 vials after my doctor wrote 3 vials for a 90 day supply, I attempted to talk to as so-called "Diabetes Specialist" at Medco…who turned out not knowing his a— from his elbow about insulin delivery via insulin pump! HA!…hardly a "Diabetes Specialist". I documented each and every Medco contact with names. dates, discussion and wrote a complaint letter to the CEO of Medco suggesting that their handling bordered on the criminally negligent and aggravated my already chronic condition. I also threatened an Insurance Department complaint. (Each state has it's own "Insurance Department" regulating insurers. Insurance Companies receiving a large amount of insurance department complaints, are subject to greater scrutiny by inspectors in each state which can result in fines.) After receiving my letter, an assistant to the CEO contacted me and I received the 3 vials as initially prescribed by my endo and haven't had any subsequent problems there. My initial contacts with Medco on this made me a ranting lunatic. I've learned that if reasonable attempts to resolve an issue don't work, I must escalate up the management ladder. This also works when dealing with property-casualty insurers.

Bamberg
Bamberg 2012-04-13 20:55:21 -0500 Report

Why does anyone think that it's OK for this health care fiasco to exist? About 40 percent of every health care dollar goes to administration; in other words, deciding who is going to pay whom and how much. When anyone tries to fix this broken system there is a well orchestrated and well funded outcry about Socialism and it's evils. What could be more evil than having sick people beg and plead with insurance companies in an attempt to ward off bankruptcy.

Type1Lou
Type1Lou 2012-04-14 11:16:54 -0500 Report

I wholly agree with you that it is not OK, but the reality is that hassles are increasingly "the Norm" when dealing with insurers. There are ways to make them accountable for their actions/inactions. It does take some documentation, time, and effort on our part as evidenced by my experience and Red Flower Lady's, but in the end, we did get good results. Unfortunately, (apologies to Voltaire) "All is not for the best in this best of all possible worlds."