Still Waiting

Well, I put in all the information for my new pump to Animas last week. After playing phone tag back and forth with the pump rep we finally got a few thing hammered out. It seems that although my current insurance company didn't pay for my original insulin pump AND my coverage says that it's covered as long as I pay the deductible and 20% of the total cost - they are still being hesitant to completely approve it.

I had to fax them 30 days of blood sugar logs (do you know how annoying that is? I HATE, and I mean HATE - absolutely Detest logging, I could barely keep it up while I was pregnant). Animas called me back later to "confirm" that my current pump is malfunctioning - before the insurance company would approve it. - it is, it's definitely falling apart. I should post pictures of my poor sad pump, maybe I will try to tomorrow.

So, as of last Wednesday all we were waiting on was the prescription from my doctor and final insurance company approval before they could finalize the whole thing. Gr. That's about all I have to say about that. It's really irritating to me. I can be a very patient person, but I would really like my new pump now. My current pump is falling apart, I question how much longer it will last me in its present state. Also, I HATE - absolutely HATE the infusion sets I'm being forced to use through my prescription plan.

I think they are a huge cause of why I've been able to get sick so easily these days. These infusion sets fail so much faster than my old ones. They are about 20 inches too long, so they get caught on EVERYTHING. I have found holes in my tubing more times than I can count with this brand. All in all I am beyond fed up. - Why is this part of getting a new pump? Well, once I meet my deductible I can get the infusion sets that I like (or that I KNOW will actually work) via the Durable Medical Equipment clause and end up paying just a couple bucks more than the prescription plan.

Kenny and I've both decided it's worth the couple extra dollars to not constantly have failed infusion set sites.

So, I'm sick of waiting now. I've been "good" and not plagued Animas with phone calls just to see where we're at in the process, but I think I might tomorrow. Heehee.

In the mean time, I'm alive and well. My little episode last week didn't linger on past Thursday. I've been catching up on my house work and errands that got seriously set back from my 2 days down and out cold.

Rylee has had a major growth spurt and is seriously taller than most of the children her age that we regularly see. I wish she'd quit growing. I miss my little infant child.

Aaaaand to finish this all off - Kenny goes back to school in a month! It's going to be an epic year, that's for sure!

Breaks, Insurance (again), and Pumps

So, I've been taking a bit of a break from most social-networking. I've still been on facebook, just not as much. It's been a nice break. Sometimes for the sake of my sanity I need to disconnect from everything.

Anyhow, I think I'll be back more regularly again.


The glutton for punishment that I am - I'm going back into dealing with my insurance company.

My Insulin Pump's warranty has been gone since February. It's been proven that my pumps only last me about 6 months at a time before I need them to send me a new one - just because I'm so hard on them in every day use. The battery case ends up cracked, the rubber on the buttons wears off leaving electronics exposed, it refuses to prime... and so on.

In the name of tradition - my pump is rapidly falling apart. The rubber over the buttons is peeling off - and I've already done my best to preserve that. I accidentally exposed it to several X-Rays last week- it doesn't seem to have done any damage, but it's just another risk to it seriously failing me soon. I've already noticed some problems where it's not actually priming even though it says it is - leaving me with awesome high blood sugars, usually overnight.

When changing my infusion site the other day I realized that I will either

A. Need to order more supplies soon

B. Go back to Multiple Daily Injections (MDI)

or C. find out exactly how much a new pump is going to cost and see if that's even an option

I decided I've got a little bit of time before I'll need to order more supplies (a few weeks) so I'll call Animas and see what we can get going for me there. I had them run the numbers with my insurance company to help me figure out how much money I'll actually have to pay out of pocket after my 20% deductible and possible trade-in value for my current pump.

No one told me it takes 48 hours for them to talk to my insurance company and figure everything out so - impatient me called them yesterday afternoon and then I felt like an idiot after they told me it takes 48 hours so they'll call me tomorrow (now today). Ah well. I'll know more at some point today, I hope.

I kind of exciting prospective with possibly getting a new pump (under warranty!!!) is that we might be able to do a CGMS system for me too - we'll meet the deductible for the year and all the rest of my supplies will be covered 100% for the remainder of the medical year. - We'll see, though. Everything is all just "possibilities" right now and nothing is set in stone.

I'm really really really really hoping it'll all be feasible, though. The pump at least. If we can meet the deductible too - that would just be awesome. I absolutely HATE the infusion sets that I'm being forced to use right now because they are all that is covered under my prescription part of my medical plan. I could get the ones that I want under Durable Medical Equipment but at at 20% copay per box - it's just not a do-able option right now.

Here's a vent - Why does diabetes have to be so expensive!? It's irritating that my medical condition takes away from things I could be doing/getting for my daughter. It takes away from going out to dinner once in a while with my husband. Gr.

My husband is so sweet, though. Yesterday I told him I was feeling bad about possibly getting a new pump because it makes me a really expensive spouse - he told me "I married you knowing you're going to be expensive. I still love you!" Okay, he's definitely a keeper and the sweetest guy ever.

Alright, so I'm going to wrap this up for now. Here's to being back to some regular-ish posting!

Recap:

Okay, I'm more of a sane person again, so I thought an update and recap would be appropriate right about now. Haha!
Starting 5 months ago I thought it would be a good idea to get some more supplies ordered on my new insurance plan through Kenny's work. I had a huge back up of my Insulin, Infusion Sets, Cartridges and Test Strips.
It had been many months since I ordered more, I figured it was about time to get going on that. I had no idea how this new insurance would work out for my prescriptions other than that it was supposed to be about $50 for 3 months of mail ordered supplies. We had only been on that insurance for 6ish months and I, at the time, was in no hurry to learn the ropes.

We confirmed that my Inset Infusion Sets were covered with my insurance plan. I spoke to my doctors office, had them call in the appropriate prescriptions to CVS. Simple enough, right? Well, I thought it was.

When I checked my order online a week later to see where it was in the process I realized that they were sending me the wrong one of 2 possible types. Figuring it was my doctors fault for calling in the wrong ones I called CVS, canceled it, asked my doctor to put through the right one.

A couple weeks later I got a letter stating that the most recent order of Infusion sets was canceled because they were not covered under my plan. ::sigh:: Oh well. I'll just call them and see what's up.

I was told that they are covered. I order them. Again a few weeks later I'm told they are not covered and the order is canceled. Repeat several more times over the course of a few months because it takes them a couple weeks to "process" each prescription then tell me it's not coming.

Then we come to January. I finally get a 4 way conference call going on and between everyone we finally figure out what exactly is covered by my insurance company, what I can order and what the exact code I need to give whoever I talk to next time I have issues.

Called my doctors office, yet again, had them send over that exact order to CVS. Who then took a full week to process the prescription, and I told them I needed it expedited because they had screwed around with me for so long. CVS also screwed up and instead of Over-nighting these Infusion Sets to me (after we informed them I need urgently) they shipped the package, not 2day, or 3day but UPS Ground. From Florida to Washington. Suffice to say, I was upset.

THEN: (Oh yes, there is more) I get a call: they sent me the wrong ones.

How could this happen? I was out of Infusion Sets. I was already back to shots for a couple days which was causing me problems. I wanted my Infusion Sets. I needed my Infusion Sets. I need to be on my Insulin Pump. Life is so much better when I'm on an insulin pump with a little munchkin to chase after. Yes, there is tubing that she could accidentally rip out, but that's not so bad compared to actually feeling good and up to taking care of her.

I sat down and cried after that call. Kenny got on the phone after he was already an hour out of town. He pulled over on the side of the road and spent an hour on the phone doing battle for me. He got them to expedite the processing and overnight the RIGHT prescriptions. I had to wait an extra day because my doctor wasn't in the office that particular day. At least I was still going to get the right prescriptions by Thursday.

....or so I thought.

Thursday came, I waited around all day for that box of prescriptions to get here, it finally came...

...they were the wrong ones. Seriously. The ones that were supposed to be the "right ones" because they sent me the "wrong ones" turned out to still be the "wrong ones."

I, once again, wound up waiting around ALL.DAY. on Friday to get that original package that took nearly 2 weeks to get here. It came and those were the right ones!

The funny thing is that when I went to put one in today I realized that the tubing is nearly as long as I am tall! I was supposed to get the 23" tubing not the 43" tubing. I'm 5 feet tall, I don't need that extra crap to get in my way or for Rylee to play with (although she is very good about leaving it alone). Oh well, I can deal with that because at least I'll get my insulin delivered to me properly.5 months of insanity. Mostly finished. I'm sure I will run into problems next time I go to order because I'll need to make sure I get the right tubing, so I'll allow myself an extra month to let them screw up. I can sleep better now. No more major breakdowns. Much better, much happier. Now back to a more normal kind of life, hopefully without all this drama!

"Thank You for Calling CVS Caremark, We appreciate your business"

Dear CVS Caremark,

I don't buy that line you feed me every time I call you.

You have put me through 5 months of hell and I just found out it isn't over yet.

You see, I am a very patient person, willing to let people screw up and even screw me over because it's in my nature to instantly think "well, maybe they are new and didn't know what they were doing" "maybe they were having a bad day," and I have given you every possible allowance over the last 5 months.

When you jerked me around telling me that one life-preserving prescription for a Type 1 diabetic IS covered then turn around and say "Gotcha!!! Haha!" and it's not - I was a little irritated. Still willing to work with you. Then you did it again. And again. And again. Aaaaaaaand just for good measure, you do it again.

I have wasted more of my precious 700 cell phone minutes with you than any other person or company in my life. Calling, pleading with you guys to work with me because I am more than willing to work with you.

You see, I use an Insulin Pump, being a pharmaceutical company you should be able to derive from that that I am a Diabetic. Maybe I should clarify that I have Type 1 diabetes and don't appreciate the callous eye roll and casual approach to my actually quite serious chronic illness due to all the misinformation going around.

I pay good money to you every month to be able to live my life to the fullest with what resources are available to me. You are there to help people get the drugs that they need for whatever reason, but you are completely incapable of accomplishing that in a satisfactory manner.

After finally figuring what string of magical baby words to say and how slow I need to talk to you guys for you to understand how to help me - you finally are able to get a prescription that will work for me. After 5 months you are finally able to get me a prescription that will work - because I got a 4 way conference call between me and 3 divisions of your company and between all of us you "figured it out."

I thought that maybe my problems with you guys would be over at that point how hard is it to get a prescription that was faxed over by my doctor the same day mailed out to me?

Evidently you are incompetent in every division of your company. You tried mailing and charging me for 3 other things that I do NOT need, I did NOT order and my Doctors office did NOT fax a prescription over for. I called, yet again, and cancelled those, telling you in the nicest way I could while being infuriated not to ever order something I did not authorize again.

It took you 4 days to ship my prescription from the time the fax came through. How on earth can it take that long? How could you not have gotten the message that I NEED these? Especially after my husband called and told you to speed your process up and overnight my prescriptions for me. It's been 5 months and I'm on my last infusion set.

I am not a swearing person. My parents are great people and taught me not to use such language. I generally don't. Today I am pissed. Today I would just love to cuss you out like I have never done before. Today I found out that you did not overnight my prescriptions, you sent them via UPS Ground, from Florida to Washington. What the Hell!? I'm not getting them until Friday!!! What part of "It's been 5 months of trying to get a prescription from a company we pay good money to so you damn well better overnight those to us" didn't you understand!?

I know you don't care, but I am Pissed. Now I have to use shots for 3 days sending me into 3 days of shitty blood sugars and by the time I get my new infusion sets I'll just be starting to get the control back on shots - but it doesn't compare to the control I have on my Insulin Pump.

Thank you SO much for condemning me to 3 bad days. I have plenty of friends who were more than willing to send me a couple extras to last me until my prescriptions came but you were supposed to overnight mine, so I declined. Now it still won't matter because I'll have my own by the time any extras are sent to me by any friends.

If I didn't have to use you to get my damn prescriptions because there is NO pharmacy within 281 miles that carries these prescriptions I would never use you again for the rest of my life.

"Thank You for Calling CVS Caremark, We appreciate your business"

Bite Me.

Won't it stop already!?

I'm SO frustrated I could cry.

I've posted back and forth about my battles with our stupid ::insert expletive here:: insurance company. I was so fed up with them in November that I said "screw it!!!" and didn't order because they were once again telling me that they will NOT cover the Infusion Sets that I needed (after they told me they did...).

Of course that was the wrong response because I knew I was running very low on my back up supplies (down to my last box) and I'd be lucky to make them last through January - but I did.

Tonight I checked online to see what the status of the order I FINALLY got put through on Friday after a 4 way conference call with 3 different divisions of the Caremark prescription company and myself. I NEED those to ship out because, like I said, I only had one left. I found that the order had **3** different items in it! What the heck!? I only wanted my INFUSION SETS! NOTHING ELSE. I don't want to get charged $150 for crap I didn't order!!

How many people does it take to get the freaking order RIGHT!? It's been 5 months now!!!! 5 Months of dealing with stupid incompetent idiots who can't figure out something SO SIMPLE!

I'm so frustrated I could cry.

I called them and got it taken care of, or... ...I hope I did. Of course they can figure out how to screw it up again. They always do and I wouldn't put it past them. That put me over the top, though.

I've got a raging gum infection. I've needed SERIOUS dental work done since last May but we couldn't pay for it at all. Now our dental plan/coverage changed this year so all the work (root canals, crowns...) is 100% covered. I just have to wait 3 more weeks. This DANG infection is causing havoc with my Blood Sugars. I've seen above 400 mg/dl more times today than I will admit. My most recent reading was that blasted "HI." I want to curse every time I see that, except, I do my best not to.

It's not a nice friendly meter saying "HI! I'm glad you came to check in with me!" Its cruel and sadistic. "HI! Your blood sugar is somewhere over the rainbow at 600+ something, and you probably should take some insulin for that and get it back down to something I can read."

I'm so frustrated I could cry.

I used my last Infusion Set tonight. In faith that my new ones would come to me sooner than I expect.

I've had my Insulin Pump running at +50% all day and it hasn't made a dent in my blood sugars. I just want to eat normal meals! I've got it running at +80% now to see if that'll make the necessary dent I need. Combined with the changed Infusion Set. I'm sure the last one was bad. I've been using them much longer than I should just so I could stretch them out this long.

I'm so frustrated I should cry. I want to cry. I won't cry. It won't help with my blood sugars.

I'm going to go pee for the gazillionth time today and go to bed.

I was RIGHT!!!

So, I have had an AWFUL time with the insurance company lately.

In SEPTEMBER I tried to order my prescriptions for the first time since switching insurances. When I was checking my prescription account at Caremark I realized that they were trying to ship all the prescriptions to me at once (which is a HUGE bill!). They didn't call me to ask what ones I wanted filled or to even let me know they were being shipped.

I just asked for my prescriptions to be transferred to the pharmacy, that was it.

Anyway, I was looking at the prescriptions they were trying to ship me and realized they were trying to ship me the wrong Infusion Sets.

Fast forward 3 weeks later I have been trying to call and figure out how to get the RIGHT ones for the last 3 weeks. I had been told that the Prescription Plan did NOT cover the infusion sets but the Insurance Plan did under Durable Medical Equipment - and back and forth I went with Representative to Representative. Being told one thing then a contradicting one.

I finally called Animas up and they were SO very helpful. Told me that they were in fact covered under DME (Durable Medical Equipment). Silly me didn't ask them to check on the prescription plan. I called BACK to Caremark (the Prescription Plan) and asked them WHY they had been in the process of shipping me Infusion Sets when they were not covered.

Evidently that was the right question AND I finally got a hold of the right person. I did make sure this time to explain everything very slowly, articulately and phrased in a very specific way so no mistake in what I was saying could be made. He told me that the proper Infusion Sets were actually covered! He apologized over and over for his Colleagues and their lack of knowledge about their profession. It was nice finally getting a competent person to talk to!

So, I was right. I knew they would be covered being as I was going to get Infusion Sets in the first place, although they were the wrong ones, there should have been no reason to deny Infusions sets made by the exact same company - just a different type!

I wish people would actually care about their jobs enough to learn about the things they are supposed to help people with! Especially in the medical world!

I'm beyond thrilled now, I would have had to meet a Deductible for the DME supplies - which would have hurt pretty bad.

Next step: Getting the right Prescription Written from my Doctor that wrote it wrong in the first place!!!