Later today, I will finally get my xolair shot, only three full months after I was supposed to get the last one.
It took me being on the phone with several different people for hours. It took my shot nurse doing the same. It took my medical advocate doing the same. It took faxes and pdfs and tears.
Those of you who have been following the saga know that I used to pay $9/month for my xolair (thanks to Genentech’s xolair assistance). Blue Shield told me for over two months that I would pay $125/month + 40 for the nurse visit. Yet I couldn’t order the drug because BS was telling the pharmacy something else. Then BS told me that they had been wrong–all five people I’d talked to were just wrong–and that my copay was just under $1100/month (+40).
Here’s what we now know actually happened:
BS was wrong on their authorization form–they listed a pharmacy that was actually out of my network (“that was an error”); that cost me a week.
BS was wrong when many, many people told me to set up an account with the pharmacy and to order the drug. The letter they sent me, addressed to me, addressing me in second person (“your provider . . .”), was, they admit, “confusing” as it seemed to also tell me that I had to order the drug, when, in fact, the doctor’s office was supposed to do it.
BS was wrong when they tried to bill $1100–both because I was apparently not supposed to order the drug myself, but also because that copay would only apply to this drug if I had an out of network doctor. My plan is the UC Care plan, made especially for UC Davis Employees who use UC Doctors. My doctor works at the UC Davis Medical Center. When I get bills from there, I have to write checks to the Regents of UC Davis. When I got switched to this plan, I called BS to confirm that all of my doctors, including this one, were in my network. So how could I possibly expect them to get this right, even when the authorization lists this very doctor as being one of their providers? Silly me.
My copay is actually zero. I will have to pay $40/month to see the nurse, so under the new insurance plan, my cost goes up $31, which is, of course, fine. I just wish I were allowed to make this many mistakes as a patient/bill payer. I just wish my lungs hadn’t been hurting for a couple of months. I just wish I could get all those hours back.
And I wish they weren’t giving me more BS about a procedure I need on my neck, turning it down.
How am I supposed to trust them now?
(In other news: my students’ stand-up performance is here: http://webcast.ucdavis.edu/llnd/1bf40024 I’m the MC, so I do some stuff at the start and in-between. I was basically workshopping all new stuff, so it’s not polished.)
