I think my ears have finally recovered from my marathon session with our insurance. It was actually a combination of time with Anthem and then time with CVS/Caremark (our pharmacy insurance). Basically - they were telling us that for one of the meds Jim had been prescribed, he had a $10 co-pay. Now, understand - we have an HSA and our deductible is $4000. Under our plan, once our deductible is met, we have 100% coverage with no out-of-pocket. Which means, logically, there should never be anything paid beyond the $4000 nor should there ever be a co-pay. So I was on the phone forEVER trying to understand what these people were telling me. And it went from the co-pay discussion to being told that one of the medications had no prior authorization and then after Jim had been told by one person that both meds had shipped, another woman told me she was seeing that only ONE of the meds had been shipped. It was crazy. Added to all that, Anthem was giving me fits. Sunday, when I check the claims for Jim, I saw the two meds have been put through and approved. It was here that I saw the two prices (original prices) for the meds - one was listed as $20,000 and the other as $22,000. We, however, were only responsible for $4000 on the one med but nothing for the other. When I went on Anthem yesterday, there had been an adjustment, apparently and only one of the meds was listed. ARG! What the eff is going on. In the end, I'm going to have to talk to my insurance broker and see what he knows. Of course I can't remember his name nor can I remember how I'm supposed to get a hold of him. I'll ask around today at school and gear my ears up for another marathon session.
Good news however: Jim's meds have been shipped and I have the tracking number. They should be here today! Woot. Who knows what will happen next month and I'll be interested to get the bill for all of this. I'm sure that will be all screwed up.
In other news - Dezi didn't show up yesterday. I thought for sure I'd here around 7:15, "Uh HI! HI! I'm Back! UH! HOW ARE YOU!? I'M BACK. UH, Hello!?" I'm sure today will be the day. Can you tell I'm dreading this!?
I got a ton of shit done at school yesterday including finishing an IEP for Thursday, setting up two meetings for February, putting plans together for Friday (we have a 1/2 day professional meeting in the morning), sending grades to all my parents, grading papers, oh, and I actually taught all of my classes! A good Monday!
Okay well, time to get a move on. Cold weather on the way which I look forward to. Oh and we're going to the Viking exhibit on Saturday. That'll be fun.
K - I'm out. Happy Tuesday. Later!
No comments:
Post a Comment