The Five Stages of Health Insurance Grief

Stage 1: Denial. [The double entendres write themselves!] A few weeks after your endocrinologist appointment/pump supply shipment/eye exam, that bill arrives. You know the bill — THAT one. You know it’s a bill because you rip the corner off of the outer envelope and see the return envelope inside. Once you realize it’s a bill, you leave it on the kitchen counter to mature with the bananas and the cherry tomatoes. You pretend it’s not there, and that things might get sorted out all on their own.

Stage 2: Anger. The Explanation of Benefits arrives from the insurance company. You open it, and decide to go ahead and open the bill, too — just to compare dollar amounts and obscure service codes and descriptions. That’s when you realize that The Thing That’s Supposed to Be Covered, as well as The Thing You Need to Manage Your Diabetes Like A Responsible Person, will not be covered, and that you owe close to $1,200. Expletives fill the house like leftover test strips, and you toss the envelopes and papers into your purse, intending to make some very official phone calls at work the next day.

Mo' medicine, mo' problems.

For every diabetic, a stack of statements.

Stage 3: Bargaining. “I got this,” you think to yourself. “Certainly there’s a normal person at the insurance company who will understand that I need things like test strips and appointments with my Certified Diabetes Educator in order to survive. And certainly that person will see that the insurance company is wrong in rejecting my claim. We’ll get this resolved in no time!” Halfway through your phone call, however, you begin to wonder if anyone at the insurance company cares if you live or die. “If I can conference the provider in on this call, can we work this out?” you ask. “Could you pay, like, 20% of this total? Is there anything I can do to make this happen?” Sadly, no. No on all counts.

Step 4: Depression. Later that night, you reach into your stash of all-important and still-not-paid-for diabetes supplies, only to discover that you are almost out. This is when you collapse into a blabbering blob of ugly-cry, snorting and sobbing, face-down on your bed. Seeking comfort and reassurance, you go back and reread Lee Ann’s amazing post on the helplessness of negotiating with insurance companies, only to find yourself even more disheartened. “Why do we ALL have to deal with this?” you cry out into the cold, cruel universe. As you bust into your second box of Kleenex, you tell yourself that it’s all too much anyway, and that you might as well just give up — go back to the 2-shots-a-day Regular/NPH routine you subsisted on in the early 1990s. Who needs life-saving and -extending advances in treatment when trying to pay for them makes you want to throw yourself into the nearest body of water?

Step 5: Acceptance. After days on hold with medical providers and insurance companies, writing multiple letters to multiple parties who don’t want to hear from you unless you’re calling with a credit card number, you accept that, with time, you might be able to get this thing straightened out. And if not, there are options. You can always change providers, take a break from the sensors, or get a second job to pay for all the stuff that’s not covered. You can always drive a bus through the insurance company headquarters. Even if you do get all of this straightened out, you accept the fact that it will happen again next year, and the year after that, and every year that follows until your diabetes is cured or insurance companies begin to make decisions that are truly in the best interest of their members’ health.

You accept that this is the reality of health care for people with chronic conditions — at least, those of us who are lucky enough to have insurance at all. You buck up, and you pick up the phone to make another call.

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12 comments on “The Five Stages of Health Insurance Grief

  1. Katie from SF says:

    So painfully true. And worse that almost all of us can commiserate. Hope you get a nice break from the craziness soon!

  2. Fiona says:

    Everytime I deal with rogue insurance issues, I think of that John Grisham book, The Rainmaker where the whole denial thing was a big scam because they knew people would just give up. That usually fires me up enough to out-wait any run around. Call centers make me bat shit crazy though. And that’s also part of the scheme. Good luck!!!

  3. Joanne says:

    funny/sad post… and so craptastically true.

  4. Tina Kicklighter says:

    Very depressing, but oh so true.

  5. “No, idiot… Put your supervisor on the phone. What? Oh, she’s not there? Well, you’re the boss, then that means you have the power to do whatever you want and give yourself a pay increase. Oh, you can’t… THEN PUT ME THROUGH TO THAT PERSON, AND STOP ARGUING WITH ME ABOUT IT.”

    Yes, I’ve created a script based on the above scenario you write about. And like clockwork, I usually find myself angered by it by the end of a phone call.

    We must fight. For our fight. For heallllllllllth insurance.

  6. If there’s room for me to get a cheek on the bus driver’s seat and a hand on the steering wheel, I’ll help you drive that baby through your insurance company’s offices, and then you can help me plow through the walls of mine. Shit, we can collect a list of companies from the DOC, and make a cross-country tour of it. I’ll pack my bags now. I’m just not sure if I have enough pump supplies since I can’t afford them under my benefits…

  7. Jen says:

    I just found out that my insurance company is only going to cover testing up to 6 times a day, beginning next month.

    The reason they’ve restricted coverage to 6x a day is because apparently that’s what the FDA recomends…let’s not take into account what the ADA or my dr who see’s me every 3 months recomends!

    And all the research about how testing more shows us where we’re at and gives us a better gauge for getting better control…so we won’t get complications that the insurance companies will have to pay for later!

    Oooh, I think I haven’t left the anger stage! Anger, with bits of weeping every now and then.

    Such a true, but sad post!

  8. Renata says:

    Stay strong…I was glad to hear you got back up and made another call after you had a good cry. Think of all those who don’t or just can’t do it anymore. Keep fighting for them. Keep fighting for you.

  9. During my “crisis” I was getting 6-10 bills in the mail per week. When I finally totaled it all up, the sum came to over $500,000. Just a couple years ago we had a policy at work that had a lifetime cap of $100,000. Had that still been true, I guess I’d be declaring bankruptcy.

  10. Scott S says:

    This is pretty funny, but also remarkably true!

  11. Olivejooice says:

    This post is right on the money….

  12. […] They are some of the funniest D blog posts I have ever come across.  But this one about the five stages of health insurance grief really resonated with me at the […]

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