Friday, July 24, 2009

A Sequel -- Happy Times Are Here Again

It pays not to always believe health care providers when they say "no" to paying for services. On Tuesday I lamented my case in which California's MediCal system because of budget cutbacks no longer paid for my test strips used to monitor my blood glucose which for a diabetic is essential as breathing.

Today I struck gold. After 45 minutes plowing through the automated phone tree of Health Net and being placed on hold while the call was transferred to three different departments, I was promised a shipment of test strips and lancets dispatched immediately to arrive at my doorstep no later than Tuesday. At no cost. I was given an 888 number to call for refills.

First off, I want to again thank The Moderate Voice contributors for their outpouring of sympathy, warmth, understanding and outrage at one tiny aspect of our health care system that involved me. Some even volunteered to take up a collection to pay for the test strips. Wow!

My frustration reached incredulity when a Health Net insurance representative told me all supplies and replacement parts for my insulin pump were covered -- except the test strips and lancets. That conversation occurred about a month ago. No problem, I imagined, because MediCal picked up that share of cost. I was unaware at that time that MediCal stopped paying because of the budget cuts. Health Net at that point stepped in and took over the coverage.

Now, Health Net is not the largest health insurance carrier in the country. But it is big enough in which sometimes the left hand doesn't know what the right hand is doing. As is the case with large bureaucracies, it takes not weeks but months for changes to reach all the parties involved so they are working on the same page.

It also is incumbent on the consumer to plow through the automated phone trees the bureaucracies provide nowadays and have the time and patience not to buckle under the system.

The reason I went public is that it was stupid health care practice to provide coverage for all diabetic-related medical problems but not pay a measly $40 (retail) for a box of test strips that provide the information a diabetic requires to avoid all those medical costs which amounts to tens of thousands of dollars in a patient's lifetime.

I was wrong. I wasn't looking in the right places. But, it was up to me to find them. Years in the newspaper business trained me to keep plugging away to find the truth.

One wonders how many folks simply would have given up. The health care providers could care less for that's one less bill to pay.

By the way, some of the comments to my post questioned why Medicare Part D did not cover the cost of the test strips. They don't because strips are not a drug.

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