Aches & Pains Not From LAM/TSC

When this posts it will mark the anniversary of a scary moment where I thought my  transplant listing would be completely derailed.

On the 8th, a year ago, I was in a very serious car accident that could have ended my life.  I remember that time because I fought so hard to recover & it was excruciatingly difficult.  I was hit head on by a reckless driver as I was going to exercise.

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“Medical Necessity”: 2 Cringe-Worthy Words

I have an interim case manager from my insurance company helping me while my assigned case manager is away on temporary medical leave.

But as much homework as I’ve done on trying to clarify a few benefits & find information & details in my plan (now that my listing is imminent) I’ve unfortunately been given a lot of mis-information by the agents I’ve been speaking with. Even after they’ve put me on hold to clarify with their supervisors.

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The Prominent Scapegoat for “Big Pharma”

I actually am lifting this from a Facebook post I made last night referencing this video interview that I watched yesterday morning & then expounding a little.

While some of it irked me, I did at least appreciate the opportunity to see this man’s thought process.

Yes, he’s the most prominent person to champion the trend of raising drug prices to increase profit margins.

But — he’s not the only one.

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Surprise! Surprise! The Answers Aren’t Always There!

I get to join the rest of the people who are adjusting to new insurance plans this year.   My company changed coverages, albeit the changes are somewhat slight.  Some are actual improvements, some are definite changes.  Most straightforward but a few that should be simple are anything but that.

I’m having a heck of a time trying to figure out my prescriptions. The prices & classifications (tiers) are not the issue. It’s where I can get them from & how many pills at a time.  It doesn’t really say, for sure, in a clear manner.

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Love/Hate With Health Insurance

Many people don’t realize this but many common issues regarding premiums & claims were present before healthcare reform.  I even experienced them myself for a few years when I made the mistake of selecting a plan that looked good on paper, but in reality was quite the opposite. (I even found an error but was never given a way to be able to submit proof to have it corrected).  This was back quite awhile ago, & also part of what prompted me to take a position in customer service in health insurance when I found an opening a few years ago. I learned so much. Some knowledge I’m glad I have & other knowledge I wish I didn’t…

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EPIC FAILURES In Navigating Healthcare & Insurance Systems

Even though it was written by a doctor, this post still rang true for me.  I took several of these calls over time as a customer service rep, & I would try to help people sort out the messes.  In fact, even after my promotion, this most likely was what I would be doing yet today (if I was still at work and not on disability). I’d be helping both employer groups & members.  I’m still in “recovery” mode…because part of me misses helping people, but part of me doesn’t miss troubleshooting messes like this in the slightest, especially when it came to dealing directly with specialty pharmacy issues…

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Mega Mergers & Anti-Trust Issues Aren’t Limited to Cable, Tech, & Drug Companies

Everyone remembers hearing about the the giant hullabaloo that was the Comcast-Time Warner merger.  Some may even remember the 2000 case US Versus Microsoft.  Well, now we come full circle, but I’m not sure as many people know about this potential monopoly, though they should care…

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A Move In The Right Direction

I’m sure most of us have experienced this, either healthy or sick. A collection notice shows up at our door for an unpaid medical bill.  The first time it happened to me, it turned out a hospital in NY had sent the bills to a different address of record. One I had lived at 3 (COUNT IT) residences ago… I had even taken the liberty to update it right away with the hospital after each move to guard against this. Yet, it happened…

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KevinMD Had It Right: We ARE In The Hunger Games of Healthcare

Another boring “business of healthcare type post?” Really? Yes, really.  While this isn’t specifically related to my previous post, it does affect it. It also may not be specifically transplant related but it also has an impact there. I’m sure  it’s not my only healthcare pet peeve, but a larger one. It’s also one I’m sure that concerns many of us. Maybe it’s an even bigger issue than the few I pointed out in my previous post.  It’s the P “word” – price transparency.  What the heck is it? Why should we care?

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