The inhaled antibiotic for Froggy is $3300.00. Guess how much our insurance will cover? Zero, zip, nada, nothing, nil.
We're in the process of getting a prior authorization, if that doesn't work, we'll send it to CCS, if that doesn't work, we'll send it to Medicare. If that doesn't work, guess who is selling a kidney?
Her oral med is $49, also not covered. But somehow I'm not freaking out about that one.
In the mean time Froggy has no meds. I'm sorry, what was the point of insurance? Who exactly are they insuring, other than themselves? I'm thinking about writing a screenplay about a mother who loses her mind, and holds the executives of a major health insurance company hostage until they agree to pay for her child's health care. A kind of "Falling Down" meets "Lorenzo's Oil" film. What do you think? It sounds like a Lifetime movie, doesn't it?
I'm off to make more calls. Say a prayer that someone at Blue Cross has warm blood running through their veins.
8 comments:
Are you at a certified CF clinic? When Ella cultured PA, her pulmonologist put her in a drug study, and my son and daughter-in-law were provided with the medication.
WTF? That is crazy! Her medical needs should be covered. 100% civered no questions asked. I think health care in this country sucks - we all have a right to be 100% covered for health care and especially the children. Unforgivable. Just unforgivable.
I'm so sorry. :(
Beverly, that's a good question. We are at a certified CF clinic, although I'm not always sure how on top of things they are. I will ask tomorrow about the drug study. Good to know. Thank you!
Casey, you're right.
Our coverage is horrible. With our policy, insurance will only cover generic drugs, otherwise we have 100% copay. And of course ALL CF drugs are NOT generic. So everything is 100% copay. I find it hilarious that they still call it a co-pay when we're the only ones paying! Wouldn't it be a me-pay-you-no-pay policy? Hopefully CA. Children's Services will help us. Sometimes they do, sometimes they don't. It's just their call.
ai ai ai. this is crazy. just insane. i'm so sorry. jcn
The CFF.org website has a list of clinics that are in the Tobramycin drug study. Maybe you can research it on there and give the information to your clinic if they are not aware. It seems hard to imagine that they're not.
Keep us posted. You don't need that kind of grief and aggravation. Living with CF is enough.
Beverly, wonderful to know. Thank you! I think that CCS is paying for it. I'm waiting right now to hear back from the pharmacy to make sure the authorization went through. Cross your fingers!
I have everything crossed tightly for you. So very tightly!!
I'm waiting to hear and praying for your Froggy.
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