In case you have been living under a rock and were thinking insurance companies are ethically sound institutions, this is not the case. In fact, by my observations, these, big, cold, heartless grey buildings tend to care much more for their perfectly manicured lawns than for their sick clients.
Really, no other lawns are that perfect. Why does yours have to be? Oh, right, to show off how filthy rich your company is.
Before becoming chronically ill, I had regular and completely uneventful dealings with my private insurance company. After becoming chronically ill and submitting higher bills for compensation, I started to run into trouble.
Firstly, I was told that a claim form had been submitted as a copy, not an original. For the most part, I’m a hyper-organized teacher-type, and knew this was not possible. It took over two weeks, three different representatives, and what felt like hours on hold being subjected to the worst easy-listening ever made for them to tell me that I should just fax the claim form to them to clear this whole thing up. Um… guys? A fax is a COPY.
Secondly, I submitted a pre-approval form for medicinal Botox. I was approved. Great. I went to the pharmacy to pick up the Botox. Seems I was approved for the 100 unit dosage, but not the 50 unit. Officially, this drug, no matter the dosage, has only one drug identification number, but my insurance company MADE UP their own drug identification number for the smaller dose, something that, of course, they don’t tell you when you submit for pre-approval. It took much investigation and confusion before I found a pharmacist who knew their fake number so that I could get pre-approved for the 50 unit dose, but it was too late for the first round. The insurance company had effectively saved themselves $200.
I am no conspiracy theorist, but after jumping through various misshapen insurance hoops and knowing that the chronically ill are the most costly insurance clients, I truly began to think that my insurance company had flagged my account as one to screw with. They were out to get me.
Maybe this image is silly and hyperbolic, but maybe not. I’m lucky that I have had enough energy to fight back, but many chronic pain patients don’t, and insurance companies know this. While my life has not been put in danger by my insurance company, it’s not such a stretch to understand how this could happen as a result of bureaucratic delay tactics.
People with chronic pain are often struggling to achieve a reasonable quality of life, and are more susceptible to depression or suicidal thoughts than the general population. On top of dealing with the pain and the various ways it has affected our abilities, career, finances, friendships, and love lives, we also have endless appointments and brand new stacks of paperwork. Being denied the coverage to which we are entitled is mud-flavoured icing on a rock and dirt cake. This can add to feelings of anxiety, depression, making our lives that much more difficult. Intentionally making it harder for the chronically ill to access the coverage to which they are entitled is irresponsible, unethical, and downright evil.
It’s not likely that insurance companies are going to change their tune any time soon, so what can we do? Maybe not much, but as advocacy by and for people with chronic pain and invisible illness gains a foothold in mainstream medicine and society, I hope it will become harder for insurance companies to play their stupid games. In the meantime, we need to make use of legal aid clinics for people with disabilities. Perhaps it would also be useful to organize a network of volunteer “insurance doulas” who can assist the chronically ill in dealing with their insurance companies when they can’t. I know that well-known and respected migraine awareness advocate Teri Robert has intervened on behalf of her fellow migraineurs, and when I am able, I plan to do the same in the future.
Thoughts? Would you volunteer for or benefit from such a network?