Tuesday Tangent, it’s about profit, not your health.

I’ve been fighting with my insurance company, Florida Blue, a division of Blue Cross Blue Shield for over a year because they refuse to pay for any medical testing other than an x-ray or blood work.  They’ve sent me numerous letters stating that they know that I have brain lesions and spinal issues but they don’t deem MRI’s or cat scans a necessary medical treatment despite the fact that ALL of my doctors have said I need to have those tests yearly.

Recently MacGyver has had some neck stiffness and nerve pain which alarmed his doctor and prompted hime to order some additional tests, immediately.  MacGyver is a man who does not go to the doctor and even refused an ambulance when his hand was filleted open after  a muzzle loader accident.  He has paid into the same insurance plan for over 5 years and gone to the doctor twice.  By my best estimates the insurance company has made a tidy little profit of about 40,000 dollars just from my husband and yet they denied any and all testing ordered.

It’s become such a trend around the medical center that I go to that as soon as I mention my insurance company inevitably someone will tell me that they don’t authorize any testing outside of doctors visits.  I also find it odd that they have a representative who actually has an office inside of the medical practice that I go to.  That’s just off putting to me.

I don’t know what other peoples experiences have been but I’ve often wondered and then I read about a doctor in Mississippi diagnosed with brain cancer who needs treatment but his insurance company will not pay.

doctor with brain cancer

Go ahead and take a guess at who his insurance company is….if you guessed Blue Cross Blue Shield, you nailed it.

Enough is enough people.  I am sick of this shit.  If you pay for a service you should receive that service.  Why is it okay that they continue to profit year after year while we have to fight for basic rights?  It’s not okay.  It’s not.

If you live in Florida and have ever had a problem with your health insurance, you can go here to file a complaint.  If you have problems with your health insurance and you live in any other state, I implore you to get in touch with the proper agency and file a report.

Florida Blue has an annual revenue of 8.9 billion dollars.  The CEO, Patrick Geraghty earned almost 7 million dollars in 2013 and who knows how much he earns now.  Not bad for a not for profit organization huh?

I wish I could give people advice when they’re struggling to get their insurance to pay but the only advice I have is do your best to stay healthy and try not to ever get sick.

Have you ever had trouble getting your health insurance to pay for testing or treatment?  What did you do about it?


WTF Wednesday, we save lives…if you got 600 benjamins!

Shame on you Mylan!  Shame on you!

the cost of epipenTwo years ago I had a different insurance plan and when my doctor prescribed an EpiPen for my severe shellfish and bee allergies, my insurance plan refused to pay.  My out of pocket cost was just under $600 and that is one of the biggest reasons that I changed insurance agencies.

In 2007, the cost of an EpiPen was just under $100 which means that Mylan has managed to hike the price by over 500%, that’s unconscionable.

epipen CEO ScumBut if you think Mylan is an exception, they aren’t, they keep good company.   Four of the Country’s top 10 drugs increased by more than 100 percent since 2011 and six increased by more than 50%.  These are drugs used to treat arthritis, high cholesterol, asthma and other common health issues.

In August, CVS announced that it plans to terminate access to more than 30 drugs including some that are used in the treatment of cancer and diabetes.  Despite those cuts, CVS continues to break records with their rising operating profits.

Just after CVS announced plans to discontinue over 30 medications, Express Scripts announced plans to terminate over 80 of the medications that they offer.  They have also provided instructions to patients who are currently using those medications recommending that patients ask their doctors to consider “writing a new prescription for one of the following preferred alternatives.”  All the while, Express Scripts continues to bring in record quarterly profits.

Since when did we let the drug manufacturers, the insurance agencies, and the pharmacy determine what’s best for our health?

why EpiPen is expensive

When I changed insurance companies, I had my doctor write me a new prescription for an EpiPen because you need to replace them yearly.  Fortunately my cost for the medication was only $10 and I am really lucky that I got it when I did because I just found out last week that my insurance company no longer pays for the EpiPen.

If there ever was a reason to try and stay healthy, this is it!

WTF?  Do you think it’s possible to reform the healthcare industry?