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Cringe-Worthy Adventures in Health Insurance

As an IBD patient with Crohn’s or ulcerative colitis, there are several unfair, additional stressors that consume our minds, our patience, and even impact our disease activity. For me, one of the largest ones is dealing with health insurance.

Regularly, I see a gastroenterologist, a primary care physician, and a rheumatologist. I get labs and scans, I take oral medication daily and receive IV infusions every six weeks.

These things all require insurance approval and coverage. AND are all necessary for achieving and maintaining optimal “health” status for me.

That, is not a simple process, my friends.

Frustrated and infuriated with insurance denials for Crohn's

Recently I experienced perhaps common occurrence with my insurance, but it left me infuriated and wanting to warn other patients.

I receive emails from my insurance provider when claims are approved, but I do NOT receive emails when they are denied. Silly, don't you think? I do.

Anyway, I logged into my account to see that all of my services - appointments, labs, infusions, for the last six weeks have been denied. No additional information included. No explanation. Nothing.

So, I called my insurance company. I asked what gave. They told me they just needed to verify that I only had one source of insurance.

Because my husband's company is switching insurance providers at the beginning of 2020, my current provider decided that meant they weren’t really sure if they needed to cover me through the end of 2019, so, they didn’t.

WHAT?

Did they call me to ask this simple question?

No.

Did the send me any communication about this?

Nope.

If I hadn’t called them, would I instead have thousands of dollars of bills from my providers unexplainably piling up even though I met my deductible and out of pocket max this summer?

Yep.

Fighting for insurance coverage

It’s totally unfair that IBD patients are forced to fight and deal with the gross inefficiencies of the healthcare system on top of their own disease activity and stressors of everyday life, so I felt this was a critical piece of the puzzle to talk about.

Insurance processing, gross incompetency, negligence, etc. - it’s one more thing we as patients must be aware of, we must stay on top of and vigilant about.

In my opinion, being proactive is the only way to fight this fight because at the end of the day, the only people who have your best interests in mind as a patient is YOU.

Finding support to deal with insurance issues

To follow that up, there are some amazing support systems out there, although they’re often few and far between. For example, my infusion center has a billing department, and they are constantly aware of things before I am.

In addition, when it comes to my infusion-related claims, they are often willing and able to go to bat for me and to be the intermediary between myself and the insurance company.

When you find a provider that offers this, it’s incredible to see someone putting out the effort for you, and again, in my opinion, it’s critical to thank them endlessly and profusely.

They are advocating for you, and possibly even reducing the load of additional emotional stress you are forced to carry, and in this arena, there aren’t many people willing to do so.

I write all this to say that I see you, as patients, and I feel all of the empathy towards these unnecessary and exhausting battles we are all forced to fight which makes no sense and could be completely avoided.

This season, pleaser know you're not alone in these challenges, and we’re here for you if you need to vent.

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