Insurance Coverage Blahs

This was just one of those days I wish I could write off…

It started with me packing Hannah up for her biweekly Cerezyme infusion.  For me, I was running on 3 hours sleep, and Hannah was cranky about 5 minutes into the 30-minute drive requiring a LOT of mommy singing “Wheels on the Bus, Ice Ice Baby, and Old McDonald”… over and over and over again.

While in the waiting room, there were two young kids (about 3 and 2 I guess), and they were fighting at the toy wall while the mother was at the window.  The little girl (about 2) started screaming at the top of her lungs.  Ear piercing, mind numbing screaming at her brother.  The mother did not flinch.  The other family that was waiting and I kept looking at each other like “Come on mom, deal with this” while nurses started pouring out the door to see what that horrific noise was.  It must have lasted at least 3 minutes, no exaggeration, before the mom came back acting like “yeah, whatever.”

It freaked Hannah out after about a minute, and we moved to the other side of the waiting room (which is not that big, mind you).

We finally get into the nursing room, and they start to do Hannah’s BP and temp.  Hannah’s infusion nurse, Mary (whom I adore) comes in and tells us that they don’t have her Cerezyme.

Apparently there was a huge ‘thing’ last week about Cigna, our new insurance company, refusing to cover Hannah’s Cerezyme treatment because she has neuronopathic Gaucher’s disease.   There were a lot of phone calls made on our behalf late last week between the infusion center and Cigna, and they finally got Cigna to agree to cover Hannah’s life-extending treatment.

I could make a whole rant on the insurance industry not wanting to cover type 2 and type 3, but I don’t feel like it right now.  Just know it is in my head.

Hannah’s infusion nurse apologized for forgetting to call me that it wasn’t there.  So we headed back home.  Another 30-minute drive with a toddler who hates being in the car for more than 10 minutes.

THEN, there was the fiasco with trying to get the process started for Medicaid to cover Hannah’s over-the-counter meds.  We have done everything we were told — get the prescription, tell the pharmacy what the plan was, etc.  CVS could not figure it out.  They said they required certain codes to process it, but Medicaid could not give out those codes.  Huh?!?

Finally, I contacted our awesome Katie Beckett case manager who offered to help straighten everything out for us.  I tell ya, she sure makes up for that horrific case manager we had in Texas!

We have to go back on Thursday for Hannah’s Cerezyme treatment now.  Better late than never.  I am so thankful that our infusion nurse didn’t give me a heads up that this was all going on last week — the stress of Hannah losing this treatment would have been a nightmare for us!

This was all done by noon.  Needless to say, I was ready to write the morning off…