I went to the Dr. the other day b/c I was having chest pain. I know why. I was stressed to the max having to deal with all of Reagan’s super expensive medication that she was close to running out of. Oh the joys of switching insurance co’s (her insurance co. last year, went under). So we’re back with Humana. They are probably thinking, “not these guys again!!”
I’ll spare you the nitty gritty details, but the reason my heart started feeling like it was being attacked is b/c Reagan’s meds would be denied. After an initial (3 hour call) with the Humana pharmacy and their complete confidence in filling Reagan’s medications, no problem, I decided to proceed with them as our new pharmacy. But after many hours, days and three weeks of follow up, I was days away from being out of medication on multiple meds. The thing Humana forgot to mention is how ridiculously long the process would take and how three medications needed a Dr.’s prior authorization to be dispensed. So while waiting, three medications were denied coverage, and then expedited appeals and peer reviews were required.
When we finally got to a point where things seemed to be on track, Reagan had one day left of one medication…it couldn’t be re-filled locally b/c CVS was showing that Humana filled it. But Humana couldn’t provide any information on when it would be shipped, I was only told, it’s in process somewhere in their warehouse. I imagined the millions of subscribers Humana might have and thought of that warehouse and wished I was able to go down the street to my local pharmacy. So after paying $25 for that medication days ago, if I needed it tomorrow, it would be $300 at CVS since it was too soon to refill. But alas, hours of phone time later, I had an override code, making that a $10 medication and Reagan not running out. #stressedtotheMAX.
This happened again with another, more expensive ($750) medication. She was almost out, I had paid…but it had not shipped and no one could tell me when it would ship. CVS couldn’t order it b/c the actual cost is $2500 and they needed approval from the CVS manager AND I had to confirm I would pay it. I needed another override code. Luckily the medicine arrived on the last day of medication we had.
So I didn’t really spare you the nitty gritty like I said.
Back to my Dr. appt and my chest pain (which turned out to be stress induced reflux). I told her I knew why it I had it, I was stressed, due to the above and she said, “Having a special needs child is relentless.”
That word has continued to stick with me. She’s right, it is relentless. There’s always a crucial battle to fight. Medications, therapy, formula, feeding supplies, measuring her food, giving her enough calories, but not too much protein. Managing sicknesses to avoid the hospital, juggling multiple dr. appts and blood draws and trying to sprinkle some fun in too. It’s hard.
So imagine, when I think the medication battle is over, and just this week I get a call from her case manager. “Hey Anne-Marie, it’s L the case manager…listen, another one of Reagan’s medications was denied. Try not to panic, we will do the expedited appeal, get authorization and then do another peer review, it can take up to 3 business days.”
Another medication, down to the wire. Why is it always down the wire? (I’ve been working on this all month). And this medication retails for $16,000/month. And why are these meds so expensive? Can we just praise Jesus we’ve met our deductible in the first month of our insurance plan because of Rob’s cost/analysis spreadsheet genius-ness?
So, I just said “Ok” and sent one email to the Dr. office and left it up to God for the decision to be made in time.
I told God I can’t fight this fight. I have been fighting and crying and my body hurts. I don’t have the energy to fight or worry. I need you to fight for me. And my thoughts lately (from God) have been two words. PRAISE HIM. When trouble comes, praise Him, when it doesn’t make sense, praise Him. When you don’t understand how it will work out, praise Him. So that’s what I did. I hung up and I didn’t think about it again.
An hour and a half later, the medication was approved. Why didn’t I have this posture three weeks ago? I could have saved myself so much anxiety and stress! An hour and a half…I still can’t fathom it. The only thing that had changed from when I started this process to this one final medication was I fully trusted God.
That same day, I had taken my car to the dealer for a routine service. My car has 170,000 miles on it and ZERO warranty, it’s nine years old. I get a call from my service rep, “Hey AM, we need to talk about your car…there’s a repair that’s needed, it’s $2,500.” [GULP]. Again, my posture is to praise God and I ask him to please handle this…somehow.
Rob sends her an email and just asks if she can do any better on the price and we leave it at that. The following morning, we receive this:
I wanted to give you good news first thing this morning. We contacted Lexus on your behalf. Due to the fact that you are a very loyal customer, Lexus has decided to cover the repair 100%! We are steadily working on it, but I wanted you to start out your morning on the right foot. I’ll let you know how the repair is going later today.
ARE. YOU. KIDDING. ME.
Covered. Paid for. And all I kept thinking was, God is relentless for me. God is continuously pursuing me, covering me and unrelenting in caring for me. And, he never tires in caring for my needs, Reagan’s needs or our family’s needs. What an amazing reminder I was given this week. God is in everything…in getting a medication approved in record time and in paying for my car repair. Relentless.