F*** you Blue Cross/Blue Shield!!!!!

[Joanne98]

My apologies for the short diary. It is not going to be much. I just need to rant against the assholes that are Blue Cross/Blue Shield. So please, just bear with me and hear me out so I can get this out of my system.

Tx Liberal 4 Ever's diary :: :: Mr. Tx Liberal 4 Ever suffers from high blood pressure. He's had for several years now. He's gone through many tests to determine why he has it. But they couldn't find out why he has it. He just does. Anyways, my husband is swedish. Yes, he's from Sweden, the dreaded "socialist" country. His mom suffered a stroke in 2005 that left her in a coma for a month and unable to speak or walk. But you know what? She pulled right through with proper medical care and months of speech and physical therapy that did not leave her with a bill that would have spelled the end of the comfortable nest egg she and my father-in-law had spent their whole lives accumulating. They like to mention how had she lived in America, they would have been ruined financially with her hospital stay. All they had to pay was $15 a day and that was to cover the food.

To get back to my topic. When I married my husband, he was still in Sweden. So when we moved to the States, he brought enough of his blood pressure medication to last him for several months. Well, his medicine ran out not too long ago and the headaches started coming. He is a very stubborn, btw. Typical Gemini. Didn't want to see a doctor. Then one day he got a headache so bad, he reluctantly made the call to a doctor and scheduled an appointment. So we went yesterday to see the doctor. His blood pressure reading was 210/120. My mouth hit the ground. The doctor immediately gave him a pill to help bring the pressure down and a couple more to last the next few days. I thought that was so considerate of her. Sure enough, 10 minutes later his pressure was 150/98. Not in the normal territory but a lot better than where he had it before. So she prescribed him the same medication he was taking in Sweden since it was helping him keep the pressure normal and steady. She also scheduled him for some lab work (urine and blood samples) for the next day. My husband was happy. Well....not for long, at least.

When his medicine was ready at our local H.E.B. pharmacy, we both went to pick it up. He handed over his insurance card to the attendant there. Then a couple of minutes later she came back with a sheepish look in her eyes. I knew it.

"I'm so sorry, sir. But your insurance won't cover your medicine."

I started cussing in spanish. I threw out every single spanish cuss word I had learned from hearing my dad and uncles and that my grandmothers had admonish me to never say (since proper ladies are not supposed to curse). "Pinche" here, "Culero" there, a little sprinkling of "Bastardos" to finish it off. My husband just grew red in the face. He knew I was mad. I know I was making a scene but at that point, I didn't care. Fucking Blue Cross/Blue Shield. After I settled down, the attendant said she would call our doctor and ask for a substitute that the insurance would cover. I asked her (of course I knew what the answer was going to be) if this happened daily and she answered sadly "All the damn time."

So....Blue Cross/Blue Shield....FUCK YOU!!!!!!!!!!!!! After this, I am even more serious about getting you all blood sucking bastards out of business!!!! You have no right! Let doctors help their patients!!! If you all had any soul left in you, you would realize the harm you all are doing in preventing doctors from doing their job correctly. Step the fuck aside!!!

Okay, now I think I need some of that high blood pressure medication now...

http://www.dailykos.com/storyonly/2009/9/1/775316/-F***-you-Blue-Cross-Blue-Shield!!!!!

[laughingliberal]

1. Oh but you wouldn't want a government bureaucrat between you and your doctor!

:sarcasm:

[CurtEastPoint]

2. You beat me to it. Why can they not see the idiocy of that argument? n/t

[valerief]

7. Idiots don't see idiocy here in our Idiocracy. nt

[elleng]

11. 'THEY' simply don't understand how the systems work;

its plain ignorance, for which they are largely NOT at fault.

[Shallah Kali]

22. No, that is that job of the insurance company bureaucrats!

Can't have them going jobless because a public option or medicare for all drove them out of business walking the stree with signs saying "Will Deny Healthcare For Food!!!" can we?

:sarcasm:

[Cronus Protagonist]

3. I signed a document at Rite-Aid and I get my BP meds for $15 a month

Perhaps this might also be available to you. There was no test or anything, just a signature was required.

[barbtries]

5. if you have the right prescription

my bp went all haywire earlier this year, and the lisinopril i'd been taking wasn't cutting it anymore. i could get that for $4 at kroger, $10 for 90 days' worth. now i have to pay $30 or $45 for a 90-day supply. it's not that it's so prohibitively expensive, but look at how much MORE it is than the lisinopril was.

my son was diagnosed with a herniated disk in his back - the doctor prescribed steroids. he said it would be prednisone, but instead it was some kind of "pak" with very exact instructions. Aetna paid $16 of a $56 bill - i asked how much if he'd just prescribed prednisone? $4.00.

we are all getting so, so fucked.

[Cleita]

4. The same thing happened with my husband.

We found out that renal failure was the cause of the high blood pressure. Insurance refused to pay, but the good news was that it was 100% covered by Medicare including the EPO shots that he needed. Whoever wrote that diary should have her husband tested for kidney failure.

[ejpoeta]

6. why the hell is there no discussion about expanding medicare!! it would infuse medicare with

needed funds and it's already friggin there and in place. if we make THAT the public option, then even though people have the option to buy into it, most folks that have good insurance will stay on what they have. then eventually I think most everyone would trickle on over to medicare on their own and we would have the gradual trip to single payer. insurance companies would eventually see that they could make more money being supplemental insurance providers and we would all win. Why is this not even being discussed!!

[valerief]

8. Single payer is the only player!!!! nt

[ejpoeta]

9. i would love single payer. my thinking is that if they expanded medicare,

and let everyone buy in to that then gradually people would make their way over to it and the insurance companies would end up finding a new angle to make money... being supplemental insurance. I think this is why they are fighting a public option... because they know they won't be able to compete and keep all those big juicy profits and eventually it wouldn't be worth it for them to even try. I prefer a single payer system. I think medicare could be that system, as it is already there... in place... and would cost less to expand then it would to create something brand new. if they expanded the medicare then people could see results right away instead of waiting until after the midterm elections.

[Cleita]

12. What you need to do is write your Congress critters and demand that

Medicare be made available for anyone who wants it. You pay into it with payroll taxes and should be able to access it. Of course we need to get rid of the $100 deductible and 20% copays but it would be a start. Maybe there will be a raise in P/R taxes, but I figured out between Medicare and insurance to plug the gaps, I'm paying almost 20% of my income. I think most people would be happy to pay 15% of their income for complete coverage because Medicare can do the same coverage cheaper since the administrative cost is so low. This is the way it should be done. This would be real health care reform. The rest of the protectionism being offered to the insurance companies is not necessary. Let them compete with Medicare on the open market. It would end all the abuses of denials, preexisting conditions, and high deductibles.

[elleng]

10. and bc/bs WOULD cover it if you/he were part of Federal employees health group,

as I am. (Its the ONLY benefit I get from NOT divorcing Fed 'ee husb.)

[goclark]

13. BC/BS is in bed with the Pharma's

Someone told me that I should give up my BC/BS ( that now pays 20% of my benefits) and have straight Medicare.

I don't know what to believe.
JUst getting through the complicated paper work for them takes an IQ well above mine.

I really hate the way they operate.

[glinda]

14. My husband dropped his part of bcBS and is now on Medicare. He gets better prices on his meds and

has had no problem when he has needed medical. The paperwork has appeared to be efficient also. I recommend you drop bcBS if you find a plan that will address your need.. I wish that I could but am not 65.
BTW my husband has had bcBS for about 15 yrs. It was scary for him to drop it but he was so mad at them and also we could no longer afford the 1275/mo that we were paying not including meds.

[goclark]

15. My BC/BS was a part of my retirement package

That is the issue for me --- :shrug:

[glinda]

18. So was my husband's but they calculated wrong in the amount of money to pay for it

and he was short a year as he took early buy out. Then when he had to pay for his coverage on his own, the cost was 1280 for two per month. I do not know what your circumstances nor payment per month is nor your coverage but I suggest you compare what you could get in regards to being on Medicare as opposed to staying with bcBS.

[goclark]

19. I'm checking on it as we speak

:thanks:

[glinda]

20. Good luck. :>)

:hi:

[Blue_Tires]

16. i've been saying that for years..

[cap]

17. Take BCBS to the mat...

Call your doctor and ask him if it is MEDICALLY NECESSARY that your hubby is on the pills that he took from Sweden. Not all substitutes work for blood pressure medicine.

Especially Coumadin vs Warfarin. My mom went through it. She wanted to save a few bucks and transferred to the generic. Her condition got worse.

If this stuff is MEDICALLY NECESSARY, have the doctor write a justification and send it off to the insurance company.

Get one of those blood pressure cuffs that will upload the BP readings to your computer and start keeping track. Take the BP a couple times a day...

If your husband is dancing around in some unhappy place, these readings will document and BCBS will get off their a-- real fast. I have seen them operate real quick when it is crystal clear and well documented.

Why you should have to play these eff'n games, I don't know. But I am telling you that sending a pile of paper work off to the insurance company gets them off their a--. I've been in your spot and have fought like a tigress for my husband.

If you are really p'od, write to your state insurance board and send the insurance company a copy of your complaint.

Get the records from Sweden, especially if your hubby was in a happy place like 120/80 on the old medication. If you have BCBS by the balls, their hearts and minds will follow. Get my drift.

In the mean time, de-stress --- getting your hubby in a happy spot is very important. Yoga, exercise, meditation, healthy eating, (stay away from processed foods and soda) are really important. If the doctor offers a tranquilizer, have him take it. It's not that he can't handle things. It's just that his body's automatic system needs to be quieted. If you explain it to him this way, he may take the meds.

Get yourself in a happy spot (even though you are being tried beyond all endurance) as well. Your hubby needs it. I have walked around on tiptoe at times just to keep hubby happy.

[vinylsolution]

21. BC/BS....

.... but mostly BS.

Funny how Republicans always want to put a bureaucrat between a woman and her OB/GYN.

[Crunchy Frog]

23. Is there any way that you could get the meds directly from Sweden?

It would probably be best, if possible, to bypass the American medical industrial complex altogether.