A Conversation with the Insurance Company
Remembering what happened the night my son was diagnosed.
By Tom Karlya
May 2012 — This month it will be three years. March 20, 2009 was when Rob, our youngest of three, became our second child diagnosed with diabetes.
The thought of that night still numbs me as it does when Kaitlyn was diagnosed on September 26, 1992 at the age of two. But when Rob was diagnosed, all we kept thinking was, "Again?! Really? Another?"
I can't even begin to adequately share the amount of anger that still rages inside us. It makes no sense. I guess somewhere it does, but not to us. I remember all the comments from people who thought they knew, but didn't. They probably shouldn't have even tried. I guess one could say they were trying to be nice, but I still remember:
"Well if anyone can handle this, it's you two." Ouch.
"Did he eat a lot of candy also?" Also? As if that is how Kaitlyn got it too. Stupid.
"You know when God closes a door, He opens...." Just stop, you're killing me.
"You know, my dog has diabetes." Shot that one dead where he stood.
It all seems unbelievably stupid now, but nothing was more ridiculous than the conversation we had with the insurance company at three in the morning upon leaving the hospital with a fist full of prescriptions.
Now remember, we had been at the hospital since 5:00PM Friday night and it was now 3:00AM Saturday. I found a 24-hour drugstore that filled all the prescriptions. But when the pharmacist called the insurance company he was told that Rob was not covered. The pharmacist (who was wonderful by the way) gave me the phone. Let's pick up the conversation from there, and remember that I never once raised my voice during this entire exchange.
Me: What do you mean, "not covered?"
Them: Your daughter has diabetes, your son is not covered.
Me: Say again, please?
Them: Your daughter has...
Me: I heard what you said and I know that my daughter has diabetes. My son has just been diagnosed.
Them: He will get what he needs at the hospital.
Me: He is not in the hospital.
Them: Well I'm glad to hear it was only a mild case.
Me: Of what?
Me: There is no such thing as a mild case of type 1 diabetes.
Them: Well, if he's home...
Me: They let him come home because we have much experience in dealing with this already. Do you think we can get back to his prescriptions?
Them: He's not covered. It would be my suggestion you call back on Monday at 9:00AM to straighten it all out. Have a good night.
Me: Wait please, before you go...
Me: What is your name?
Them: My name is Janie (let's say). Why do you ask?
Me: (Remember, I'm ultra calm here.) Well Janie, I'm going to do exactly as you instructed and I will call back at 9:00AM on Monday morning.
Them: That's great.
Me: And I will do exactly as you said and speak to who you told me to speak to.
Me: And Janie?
Me: My son will be dead by that time and I want to be real sure I have the correct name of the person I spoke to who told me to wait until Monday morning to call. Because that is the person who'll be responsible for his death. And Janie...that would be you.
Them: Can you hold a moment for a supervisor?
Me: I sure can Janie.
This may surprise you, but I walked out with all of my prescriptions.
It doesn't get easier with a second child diagnosed with type 1 and we surely are not happy about it. But one philosophy is exactly the same in our family: Either you control diabetes or it surely will control you. That is how we live.
So on this third diaversary of Rob's diagnosis we are two times exponentially going to continue to advocate, help, find better management, and fight to look for a cure. IT WILL COME, of that I'm sure. I have two kids with diabetes. Nice try, diabetes, but we are still going to kick your ass, and of that I'm now doubly sure. I'm a diabetes dad.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...