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hell -has- frozen over - a good report on an insurance company meeting

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Donnachaidh Donating Member (1000+ posts) Send PM | Profile | Ignore Sat May-14-11 06:34 AM
Original message
hell -has- frozen over - a good report on an insurance company meeting
Occasionally, I think we should post the good news, and this time it happened for us.

Some may know my son is a hemophiliac. He has a mild version, and for the most part, we've been able to avoid the huge cost outlays that many others with more severe problems have had. BUT -- we've always had the battles with previous insurance companies, over who was going to fill prescriptions, where he should go for treatment, etc. Some insurance companies have their own little care groups, and insist on using them, even if they cost upwards of a third more. Cronyism, basically.

My son was injured in a PE class. I won't go into the particulars, because that's a story in itself -- but he managed to *spring leaks* as we call them in both one knee and an ankle due to ONE workout one day. Joint bleeds can be a horror story for these kids. It can force later joint replacements if not treated quickly.

Well, as of yesterday we'd had him infused 3 times - 2 trips to the ER, once in clinic for hemo kids. Total cost of factor just for those three visits, almost 28 THOUSAND dollars. As a parent I was honestly crapping myself over the 20% co-pay we were facing JUST on the factor. But it gets worse --

The hemophilia doctors want to infuse him twice weekly, for the next six weeks. Total cost for factor for one week - 14 thousand dollars. Times that by six and we are really REALLY getting into huge amounts of money. They are correct in wanting to be aggressive to get the bleeds under control and get his joints some *breathing space*, but after years of doing everything to avoid the whopping medical bills I can tell you they were scaring the shit out of me. We've only had this insurance a tad over a year, and I was nervous.

Yesterday we received a call from Aetna, our insurance. It was the hemophilia nurse they have assigned to our area. She was calling to talk to us as to why we had this sudden need for so much factor. Quite frankly I was really worried we were going to be read the riot act. But I was wrong -- she turned out to be even more helpful (in some aspects) than the local hemo group we belong to.

Long story short - once we explained the what and how of the accident, she fully understood, and we were good to go. She then stated she would send us information on plans to help us cover the co-pays and we discussed other treatments like aqua therapy, so he can work on building up his joints again to avoid future injury.

I should also add that Aetna is also integrating this particular program with government programs, in order to keep their costs down. But to have a 45 minute call with an insurance company that not only was pleasant AND added aid to a scary situation -- for us that was a huge surprise.

So, this is the first time we've faced a catastrophic medical bill, but our insurance is 100% behind us, and is looking for more ways to help. I'm still stunned.

I'm the last person on the planet to say something nice about an insurance company. But I felt I needed to post this.
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dixiegrrrrl Donating Member (1000+ posts) Send PM | Profile | Ignore Sat May-14-11 08:17 AM
Response to Original message
1. It helps to hear good news once in a while,
As a human being, I am blown away at the cost of treatment for your son's condition.

As a mother of 2 precious sons, I really can feel what you are going through.

I hope you son has speedy recovery and a good outcome.

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Donnachaidh Donating Member (1000+ posts) Send PM | Profile | Ignore Sat May-14-11 09:44 AM
Response to Reply #1
4. some severe kids need infusion daily
And it's not a surprise to hear that those families have medical bills totaling a million dollars a year. THAT would have me rolled up in a fetal position even at the thought.

We used to see tiny kids, still in diapers, toddling around with helmets, double diapers and shin pads. And still bruising, but chugging along, as kids will do. It's both frustrating and amazing to see these kids.

My kid will bounce back from this probably halfway through the 6 week treatment. He's already so much better.
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rurallib Donating Member (1000+ posts) Send PM | Profile | Ignore Sat May-14-11 09:23 AM
Response to Original message
2. so glad you got good news - and what a relief i bet
I started giving blood many years ago to help a friend who is a hemophiliac (still alive at 70).
Back then he could replace the blood used on him or pay for it, so we lined up everyone we could think of.
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Donnachaidh Donating Member (1000+ posts) Send PM | Profile | Ignore Sat May-14-11 09:40 AM
Response to Reply #2
3. we still do the blood replacement if surgeries are happening
But they've come up with so many different ways of getting factor for these guys. At clinic there was a discussion about Chinese hamsters which I didn't really hear, but it had to do with the creation of factor, believe it or not.

The medical care is there -- I just wish the costs weren't so darned high.
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