These were on my drawing table today as I navigated the MA subsidized health care system. A much-needed calm, beautiful image since the process is stressful.
The problem is, things happen without anyone telling the client/patient/me, that they are happening. The issue at hand: my doctor submits a Rx for 15 test strips/day. It’s denied because the regular amount is 6 strips/day. The doctor needs to file more paperwork. She’s away. Someone else does the paperwork. It’s denied a second time. Now the doctor has to go back a third time. The insurance company decided 15 strips wasn’t “medically necessary.” “Of course it’s medically necessary!” I’m indignant, furious, agitated (not very mindful). “How do they think I take care of myself everyday?” “Medical necessity” is a code phrase. It means the insurance company needs a medical reason for the number of strips requested. And so it goes. Code words, no one explaining what’s going on behind the scenes, doctor and patient working at cross purposes etc.
This kind of bureaucracy works against the daily care of a chronic disease. Everyone talks about helping people take care of their diabetes but their actions work against providing and facilitating that care. Earlier in the day I received a call from a health insurance representative wanting to sign me up for their wellness program-a special offering to folks with diabetes and heart conditions. I declined.
Insurance companies should give away bucketfuls of diabetes test strips since frequent testing, when you know how to act on the information, usually means better glucose control.