Wednesday, January 19, 2005

Insurance Games, Part 1 of ???

Let the insurance games begin. As part of my chemo treatments I will be getting regular injections of Neulasta (to boost white blood cell count) and Aranesp (to boost red blood cell count).

I get a call at work from the insurance company (they originally called the house and proceeded to refuse to divulge any information to Sarah without a signed HIPAA release from me, but that's another story). They've certified (insurance-speak for "approved payment for") Neulasta but not Aranesp. The reason? I haven't had any blood tests that show I need Aranesp. Of course, I haven't started chemo yet either. Once I have a blood test that shows I'm anemic (and rest assured, I will), they'll certify the Aranesp. How Kafkaesque.

Oh, they also want to know if I'd be comfortable injecting myself rather than having it done in the doctor's office. They tell me it's a simple tissue injection, much like giving yourself an insulin shot (sorry, can't use the port-a-cath). They have good reason for asking: the price of the injection is apparently marked up 100-200% if purchased in the doctor's office. So, this could affect the lifetime cap of benefits under the policy.

My first thought to myself is, "Big deal! How much could we possibly be talking here?" Well, quite a bit - each injection costs in the range of $2000 - $3000. Holy crap, man! I'll be the $6 million man by the time this is through (well, hopefully not - my policy maxes at $5 million lifetime). Anyway, there are at least three nurses in the church who would probably be willing to stick me with sharp things (gleefully). All I know is I'm not taking a chance screwing one of those shots up or dropping it on the floor myself. The doctor's office gently tries to discourage me from doing it on my own (everybody's got an angle, don't you know, and it's all about money).

So we'll be getting shipments of really expensive drugs sent to the house, where they'll be stored in the auxiliary fridge next to the beer. Que redneque! Why are they being shipped to the house instead of the doctor? Apparently doctors don't like to do this - it's called brownbagging when you get meds on the cheap and bring them to the doctor for administration.


Anonymous said...

Hey Vin, Bijoux here. FYI, I didn't want to get a blog so am using the "anon" option for posting. Becoming adept at injections is really easy and there are lots of jokes you can make about it. It'll be fine, really, and is much better to do at home yourself then having to drive the car and wait around for some nurse to jam it in you where you know it's going to hurt. Since I take humalog whenever I eat, and Lantus at night, I give myself at least 4, if not more (snacks!), shots a day. Although I now find it quite mundane, people still titter when I say "pardon me, I've got to shoot up now."
You'll get used to it, I promise. xoxo, bij