We have what is supposed to be one of the best company health insurances, Microsoft’s Blue Cross Blue Shield. And it does pay for most of my treatment, except for the times that it doesn’t.
One of the preferred treatments for my chemotherapy is a hormone that increases white blood cell count. My doctor wanted me to have it, as a preventative measure for my first chemotherapy cycle. My insurance denied it outright and then again on appeal because "it wasn’t medically necessary".
So during my 11th chemo session, my white blood cell count dropped to the point that half my chemotherapy had to be left out. There wasn't enough time to get the shorts... and I mean, who wouldn't want to spend their time battling bureaucracy and filing complicated appeals when it already been denied? And don't you just love it when the insurance company decides that a treatment that's literally standard protocol for cancer is "not medically necessary"? I mean, what do those pesky doctors and medical researchers know anyway?
In a week, I am starting my second round of a different type of chemotherapy, when this growth hormone is part of the standard procedure; my insurance can’t deny it. But what they can do is deny the brand name version, which gets administered once a week. Instead, they approved the generic version that needs to be injected five times over the week, each time with a nurse who has to come over to perform the injection.
It is hard for me to imagine that it would cost more for the total of 4 shots for the brand drug vs the 20 shots plus 20 nurse visits, but it is what it is and the bureaucrats are adamant! Not to mention that it definitely more painful and more complicated for me. And, in addition to that, I’m the one that has to arrange with the nurse, while I’m weak from my current chemotherapy. Joy!
All in all, it's just wonderful to have health insurance that puts bureaucratic nonsense and penny-pinching ahead of actual patient care and expects you to have the stamina to deal with them during cancer treatments!
