Tuesday, May 14, 2013

D-Blog Week 2013 Day #2: We, the Undersigned

Today's prompt:

Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change?

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We, the unfortunate many who consistently and endlessly access medical care, petition our insurance companies to simplify said access with written materials in readily understandable language for laymen and with plenty of well-trained human beings to staff your customer service departments.

Currently, reading one's terms of service or Explanation of Benefits requires an advanced degree in Insurancese. And, as most people don't have that advanced degree, errors - and often costly or dangerous ones - are made. For example, I've lived in New York state most of my life and, in New York state, things like syringes and test strips and pump supplies are covered as Durable Medical Equipment. However, I've only received this amazing benefit for four years because prior to that I'd never had an insurance company that helped me access that coverage - I did not know how to get it, and no one was helping me do so. As a result, I lost thousands of dollars in unnecessary copays over the 19 years I've had diabetes. And this is a small error. What about the people who don't realize they need to get precertification for complicated procedures or expensive drugs? Or what about getting your bloodwork taken at a lab that is no longer covered by your insurance?

To save patients AND insurance companies plenty of time and money, we demand written plan materials in language the average person can understand so they know what's covered and what's not. We demand customer service reps who are able to answer questions and explain things so they make sense, rather than just repeating some script in Insurancese. We demand that patients are recognized as paying customers, and, as such, are be treated as the valuable people they are.


  1. So determining whether supplies are considered DME is a state decision, not an insurer's decision? I had no idea.

    And I can't begin to tell you the troubles I've had trying to determine coverage on a plan I've yet to sign up for (during "open enrollment"). They can only tell me the details of coverage after I'm enrolled, and by then it's too late to be of any help.

    I totally agree with this post.

    1. Well, that's what I was *told* at the very least. But it's insurance, so who knows if I understood it right? ;)