It has been five months since my last post, and I have learned something in this time -- getting out of debt is a process. It is something you have to be patient with because you will be much better off in the end.
While slow, the last few months have been very fruitful. I was blessed with getting a new job that along with a significant pay increase allows me to work from home 100% of the time, letting me help out if the kids are sick. The new job has also freed Terra up to do volunteer work at a local charity that helps families that are struggling (just like we were a few years ago). Sure, she doesn't have an income to help us get out of debt faster, but she's playing a key role in helping families getting back on their feet, and that is much more important than shortening our timetable slightly :).
Doing our cash-only Christmas this year slowed the snowball down, but it is always nice starting the new year off w/o any extra debt :). Now that the new year has started, I've kicked things into high gear again. I'm about $800 away from paying my car off (which makes it really tempting to just take all the money I can one month and pay it off). So, in a few months, I'll have two paid for cars and lots of $$ back in my pocket -- all to knock out the next debt which is sitting around $2800. By year's end, I should have this one and possibly the next one paid off, freeing up an additional $500 or so in cash flow. I have to say, it feels good getting traction on this stuff :). Just keep at it, and you'll hit your goals.
Thursday, February 23, 2012
Tuesday, September 20, 2011
Fall is in the Air
As summer comes to a close, I have a few things to be thankful for. The most of these is the fact that the girls have been well for about five months! This has been a huge relief to us emotionally as well as financially. Recently, they did have a cold but they were able to kick the fever in four days which is unheard of around here.
So, what have we been up to this Summer? Well, more of the same it seems :). We have been able to pay everything down across the board. No new things have been paid off, but the entire mess is lower. One good thing is that we have been able to keep Terra's check out of our budget so it is truly extra income when it comes in -- which rocks. We also have our emergency fund almost completely built back up :)
Speaking of the emergency fund, there was one thing with Ramsey's plan I didn't think I needed to do, and that was the envelope system. It's a simple enough concept -- you make a budget, then withdraw the money you need for each category and put it in separate envelopes. Then, when you need money for something in that category, you just take it from that envelope until it is gone. I thought to myself "hey, I have Quicken, I don't need this, I can keep track of it." The problem was my rational brain was making that decision, not the irrational, hungry, I want side of my brain that apparently can't estimate well :).
So, after stumbling with a few problem areas in the budget, I pulled those out into the envelope system to better mange things. In particular, the Food (out to eat), Fun, and Clothing categories where the problem children. We would always go WAY over in these areas by underestimating how much we had spent earlier in the month. By pulling the money out ahead of time, it's something you just don't have to think about. If there's money there, awesome. If not, you're brown bagging it. I personally like not having to deal with those receipts as well. I've got one transaction in Quicken instead of 14.
Because of this, we now have a bunch of extra money in the Fun envelope (who says you HAVE to spend it, right?). As that money piles up, we are planning on a cool trip later to take the girls out and pay cash for the whole thing. Amazing what you can do when you plan for stuff :)
I've got three bills in the snowball lined up for the next 6 months depending on how things go, but I think 6 months is a reasonable goal. One of the items in there is my car, so that's got me pretty excited :).
Friday, June 24, 2011
Help Comes From The Heart
First off, I just wanted to say a huge THANK YOU to everyone who donated to our campaign. I feel very humbled by the fact that we were able to raise $5450, which had a massive impact on our financial situation.
The last few months have been busy with our noses to the grindstone. We were able to pay off Terra's van as planned, and made small strides despite some dental needs that came up. But, that all changes with the campaign :)
Now for the fun bits:
We were able to pay off three major medical debts and a few minor bills. In all, these bills represent $450/month of expense that is GONE. This gives us a HUGE amount of breathing room, and allowed me to pull Terra's check out of the budget so that it is finally extra money. This extra can go for extra snowball money or fun money without impacting the established get-out-of debt plan -- which makes me very happy :). Words cannot describe the relief I'm feeling at this point.
However, this isn't the best part. I recently discovered that Aetna is reprocessing all of our Vivaglobin claims as a pharmacy benefit instead of a major medical benefit. Translation? That means that instead of each dose costing $800 per kid per month (then subject to deductibles and 80/20), each dose is $65 flat. $65!! Since Aetna's pharmacy was one of the three major debts we paid off with the campaign, we will be getting approximately $1200-$1500 back from Aetna. THIS IS HUGE :)
I'll use this to pay off the remaining balances on some of the smaller bills and use the rest to continue walking up our debt snowball. Sure, our deductible will be replaced, but we are in a pretty good place now and that's ok :).
THANK YOU again to everyone who has donated and who has been praying for our family. You can still donate at From The Heart by specifying our family in the notes, OR you could go see what other great families are being sponsored and help meet their needs :).
The last few months have been busy with our noses to the grindstone. We were able to pay off Terra's van as planned, and made small strides despite some dental needs that came up. But, that all changes with the campaign :)
Now for the fun bits:
We were able to pay off three major medical debts and a few minor bills. In all, these bills represent $450/month of expense that is GONE. This gives us a HUGE amount of breathing room, and allowed me to pull Terra's check out of the budget so that it is finally extra money. This extra can go for extra snowball money or fun money without impacting the established get-out-of debt plan -- which makes me very happy :). Words cannot describe the relief I'm feeling at this point.
However, this isn't the best part. I recently discovered that Aetna is reprocessing all of our Vivaglobin claims as a pharmacy benefit instead of a major medical benefit. Translation? That means that instead of each dose costing $800 per kid per month (then subject to deductibles and 80/20), each dose is $65 flat. $65!! Since Aetna's pharmacy was one of the three major debts we paid off with the campaign, we will be getting approximately $1200-$1500 back from Aetna. THIS IS HUGE :)
I'll use this to pay off the remaining balances on some of the smaller bills and use the rest to continue walking up our debt snowball. Sure, our deductible will be replaced, but we are in a pretty good place now and that's ok :).
THANK YOU again to everyone who has donated and who has been praying for our family. You can still donate at From The Heart by specifying our family in the notes, OR you could go see what other great families are being sponsored and help meet their needs :).
Wednesday, February 16, 2011
And So It Begins....
It is February 16th, and already we have reached that magical time where our $3500 medical deductible has been met, our $1000 HealthFund is gone, our $2000 Flex Spending Account is gone, and we are now in our 80/20 period. That being said, we still haven't got all the bills yet for the $3500 already incurred :( (minus $1000 for the HealthFund). Dealing with THAT will be no fun.
From here on out, the girls meds should cost us around $400 a month. The thing I'm MORE worried about is the fact that around $2500 is owed to Aetna's pharmacy. I know they allow payment plans, but the little bit of info I've got so far indicates that those plans are spread over a term of around 3-5 months. That means we could be paying $600 per month to catch up, on top of the new $400 per month. Needless to say, that's not going to work :). Now the worry bit -- are they going to withhold their meds until we pay off the existing balance? I would HOPE not, but who knows with the state of the medical industry these days. That being said, I'll post more when I know more.
On to Happier news.
Terra's van will be completely paid off by the end of March (or the beginning if I can work it in) about 6 months ahead of schedule. Next up, Piper's hospital bill from all of our Cincinnati trips last year will be done in another 4 months (around July). After that, Makenna's Cincinnati bill should be knocked out in another 4 months (around November). Looking further out, my car should be paid off about this time next year - about 5 months ahead of schedule. THAT is the debt snowball in action :). Four medium sized debts being knocked out as you compound their payments.
In all, that represents around $7000 worth of debt. It's not as aggressive as I would like, but well, we have some pretty serious new expenses to deal with :). On the bright side, none of this is including Terra's income, so I should be able to accelerate things depending on how many hours she can get in the next few months.
The girls' doctor is also going to switch their meds, so I'm hoping the new one is somewhat cheaper :). I'll let you know how that goes later.
From here on out, the girls meds should cost us around $400 a month. The thing I'm MORE worried about is the fact that around $2500 is owed to Aetna's pharmacy. I know they allow payment plans, but the little bit of info I've got so far indicates that those plans are spread over a term of around 3-5 months. That means we could be paying $600 per month to catch up, on top of the new $400 per month. Needless to say, that's not going to work :). Now the worry bit -- are they going to withhold their meds until we pay off the existing balance? I would HOPE not, but who knows with the state of the medical industry these days. That being said, I'll post more when I know more.
On to Happier news.
Terra's van will be completely paid off by the end of March (or the beginning if I can work it in) about 6 months ahead of schedule. Next up, Piper's hospital bill from all of our Cincinnati trips last year will be done in another 4 months (around July). After that, Makenna's Cincinnati bill should be knocked out in another 4 months (around November). Looking further out, my car should be paid off about this time next year - about 5 months ahead of schedule. THAT is the debt snowball in action :). Four medium sized debts being knocked out as you compound their payments.
In all, that represents around $7000 worth of debt. It's not as aggressive as I would like, but well, we have some pretty serious new expenses to deal with :). On the bright side, none of this is including Terra's income, so I should be able to accelerate things depending on how many hours she can get in the next few months.
The girls' doctor is also going to switch their meds, so I'm hoping the new one is somewhat cheaper :). I'll let you know how that goes later.
Thursday, November 18, 2010
Tis the Season
Tis the Season... well, it is according to the stores anyhow. Since before Halloween there has been Christmas stuff out. Anyone listening to Christmas music yet? :).
Christmas is a time where a lot of people can get into trouble. You want to do everything you can for people you care about, but your heart usually gets bigger than your wallet. Instead of stopping, most people just charge it -- and before you know it you end up getting yourself a big nasty bill for Christmas.
For the last couple years now I've been doing a cash only Christmas. The first year was a bit of a train wreck due to medical bills and improper budgeting, but things have been getting a bit better as I get more experience. Even last year, I couldn't do as much as I wanted due to medical bills, but I used those two experiences to make this year spectacular.
I had planned way ahead of time and got all the Christmas money put back for the girls this year in October. Words cannot describe the feeling of satisfaction I had when I deposited the funds into that account. No more do I need to worry about where the money will come from. No more do I need to worry about if I can get things for the girls . No more do I need to worry about the aftermath of how to pay for a debt fueled sea of disaster. It is all taken care of -- and it's going to be a blast to do the shopping.
I've felt pretty bad about the last couple years just for the fact the kids got screwed because of my poor planning and not being able to handle the financial maelstrom we were handed. Not this year though. I'm making up for those lean years and then some. I know they are too young to really know or care, but this is something I feel I really need to do for them. They have been through so much in their short little lives, I want Christmas to be spectacular for them this year.
Speaking of spectacular, we now have four debts about to fall out in the next 6 months (all pretty much at the same time). The combined payments for all of these are right around $600 a month. That's $600 I get back almost immediately as they all drop out within months of each other. That's huge, and will go a long way in bringing the next monster down. One of those four is the Van. It only has about $1000 left, and will be a big psychological win for us (actually something directly tangible for payments).
The only thing that could be a sore spot is medical expenses for the first part of next year. Our insurance resets, so we are going to be having to pay for the girls medication (retails at $2000 a month) until all the deductibles and out of pocket expenses are hit. Thankfully there is a non-profit that is going to be working with us next year to help raise funds to offset some of these expenses. "From the Heart" is a organization started by a friend of ours with the goal of helping families in need of care they cannot necessarily afford. Go find it on Facebook or Twitter and follow. It is a great organization with a good heart and very noble goal. They will also appreciate any donations you want to contribute for their sponsored families :)
I guess my only parting words of wisdom would be to not charge Christmas this year. Sure, it may be hard, but you'll be thanking me in January when that bill doesn't arrive in your mailbox :).
Christmas is a time where a lot of people can get into trouble. You want to do everything you can for people you care about, but your heart usually gets bigger than your wallet. Instead of stopping, most people just charge it -- and before you know it you end up getting yourself a big nasty bill for Christmas.
For the last couple years now I've been doing a cash only Christmas. The first year was a bit of a train wreck due to medical bills and improper budgeting, but things have been getting a bit better as I get more experience. Even last year, I couldn't do as much as I wanted due to medical bills, but I used those two experiences to make this year spectacular.
I had planned way ahead of time and got all the Christmas money put back for the girls this year in October. Words cannot describe the feeling of satisfaction I had when I deposited the funds into that account. No more do I need to worry about where the money will come from. No more do I need to worry about if I can get things for the girls . No more do I need to worry about the aftermath of how to pay for a debt fueled sea of disaster. It is all taken care of -- and it's going to be a blast to do the shopping.
I've felt pretty bad about the last couple years just for the fact the kids got screwed because of my poor planning and not being able to handle the financial maelstrom we were handed. Not this year though. I'm making up for those lean years and then some. I know they are too young to really know or care, but this is something I feel I really need to do for them. They have been through so much in their short little lives, I want Christmas to be spectacular for them this year.
Speaking of spectacular, we now have four debts about to fall out in the next 6 months (all pretty much at the same time). The combined payments for all of these are right around $600 a month. That's $600 I get back almost immediately as they all drop out within months of each other. That's huge, and will go a long way in bringing the next monster down. One of those four is the Van. It only has about $1000 left, and will be a big psychological win for us (actually something directly tangible for payments).
The only thing that could be a sore spot is medical expenses for the first part of next year. Our insurance resets, so we are going to be having to pay for the girls medication (retails at $2000 a month) until all the deductibles and out of pocket expenses are hit. Thankfully there is a non-profit that is going to be working with us next year to help raise funds to offset some of these expenses. "From the Heart" is a organization started by a friend of ours with the goal of helping families in need of care they cannot necessarily afford. Go find it on Facebook or Twitter and follow. It is a great organization with a good heart and very noble goal. They will also appreciate any donations you want to contribute for their sponsored families :)
I guess my only parting words of wisdom would be to not charge Christmas this year. Sure, it may be hard, but you'll be thanking me in January when that bill doesn't arrive in your mailbox :).
Sunday, July 4, 2010
David 1, Goliath 0.
We just found out this week that Aetna has APPROVED my daughters treatments. I'm not sure whether it was the second appeal (or second level appeal as they internally called it -- a source for more confusion about what was going on), the extra info the Doctor submitted, or the fact I had to submit a fax to let the Doctor appeal on our behalf. Frankly, I don't care at this point, because I'm sure whatever process that was involved isn't meant for mere mortals to understand. I'm just basking in the glory that I don't have to drive 4 hours a week for treatments now, and that we aren't saddled with over $20,000 of outstanding medical bills for 3 months of medicine.
You heard right folks, because it was on appeal, they are covering all of the past treatments up until now. This is HUGE, and means I can get back to working my debt snowball instead of piling money up to pay for potential bills. It seems like it is just in time too, because I just discovered about 2" of standing water in the bottom of my furnace due to what probably is a clogged drain pipe. I need to get a service tech out to tackle that one ASAP :)
Wednesday is our first try at doing the treatments at home. We've received all of the supplies for a month, so we are set to get this going. Hopefully it is a bit easier on the girls being able to do it here instead of there. It should be more comfortable in any event.
You heard right folks, because it was on appeal, they are covering all of the past treatments up until now. This is HUGE, and means I can get back to working my debt snowball instead of piling money up to pay for potential bills. It seems like it is just in time too, because I just discovered about 2" of standing water in the bottom of my furnace due to what probably is a clogged drain pipe. I need to get a service tech out to tackle that one ASAP :)
Wednesday is our first try at doing the treatments at home. We've received all of the supplies for a month, so we are set to get this going. Hopefully it is a bit easier on the girls being able to do it here instead of there. It should be more comfortable in any event.
Tuesday, June 15, 2010
Aetna, why do you hate your customers?
While being busy trying to pay off past medical bills, I have been somewhat tuning out of my mounting new bills. After taking down four of our old ones (only one left!!), I started to turn my attention to the new ones. We have already hit our out of pocket max, so all of the new charges from Cincinnati from here on out will be covered (those Aetna pays for) so I've set up payments for what we incurred to hit our max.
This, however, is the proper start of my rant. A little back story if you will....
Our daughters have been fighting infection for the last two years. Serious infections. You get a cold and have pneumonia in three days kind of infections. You have eight ear infections in six months kind of infections. You have to go to infectious disease doctors to get special antibiotics because run-of-the-mill drugs don't cut it anymore kind of infections. You have to take a low dose antibiotic just to try to function in society infections (and still get above mentioned infections).
Throughout this time, Aetna was actually being awesome about things. They were covering the plethora of doctors and specialist visits at the said co-pays and all of the medication. Granted, I incurred nearly $17,000 in out of pocket expenses during those two years, but we were keeping our girls relatively healthy (even though we couldn't really take them out into the public). We were seeing specialist after specialist and doctor after doctor until we finally exhausted all of the resources in Indianapolis. We knew they both have a compromised immune system, but no one could tell us what was wrong or how to actually treat it. So, we just kept submitting all the claims and visits to Aetna and went on our merry way, thinking we were going to have to keep the kids in a bubble their entire lives.
Our infectious disease doctor referred us to a pair of immunology specialists at the Cincinnati Children's hospital, so we made an appointment, packed up the kids and headed out.
About all that we knew for certain about the girls is that their MBL levels were abnormally low or non-existent. This is important because this protein plays a big role in letting your body know there is an infection. Anyhow, after meeting with the new doctor, he said that the MBL was concerning, but shouldn't be causing this (based on other cases he's worked on). Twelve vials of blood from each kid later, we had a large panel of tests to try to figure out what is wrong.
After a few weeks, and after Aetna gladly paid for the facility, doctor's fees, and labs (aside from my co-insurance), we went back to discuss the results. At this point, they were still in the dark, but it is obvious they have something rare and it will take a lot more research. In the mean time, we decided to switch their prophylactic antibiotic to something stronger to help keep of infection. Like clockwork, the girls got sick again on the new antibiotic (our typical cycle was every two weeks). After consulting with Dr. Kumar, he was very concerned that they still got sick, and decided to break out the big guns to try to at least get them healthy while we tried to figure this out. He decided to switch them to Immunoglobulin G.
Our rep at the hospital called Aetna to get things pre-approved and to make sure that the treatment was covered and got the all clear. She called us up after that was settled and made our first appointment to come in. So, on our third trip to Cincinnati from Indianapolis we got our first infusion (sub Q, in the belly). We were simply waiting on Aetna to approve a home health care company to supply us with the meds and pump so we could do it at home. We figured we would have to come back maybe once more before this was taken care of, but little did we know Aetna in reality hates their customers.
We made a fourth trip, then a fifth trip, then found out the bombshell -- Aetna had denied the treatment for the girls. The thing is, after getting these treatments for three weeks, the girls had shown a dramatic improvement. They were playing, and I mean they were playing HARD. They probably never felt this good in their sick little lives, and actually got over a cold on their own WITHOUT any extra medication. This miracle drug had completely changed their quality of life, and Aetna was wanting to take that all away.
Our Doctor filed an appeal on the decision, but wanted to keep treating the girls because it was obviously working. Thankfully, he has the hospital holding the charges on the medication until this gets straightened out. Aetna has up to 30 days to respond to an appeal, so we waited, and kept driving back and forth from Indianapolis to Cincinnati to get life changing treatments for our girls.
After the 30 days had passed, Aetna finally responded -- with another denial stating that they don't cover IgG treatments for what the doctor had said he was treating them for because it was "experimental". Obviously, the experiment worked because our kids were finally able to be kids. He called and talked to the director of Aetna and found that there was a very specific black and white list of what they approved this medication for. The problem is, we don't have a diagnosis yet -- we just know the immune system is involved. So, he worked up a second appeal and drew more labs to get more ammunition.
Keep in mind, Aetna has been happily processing and paying for all of the facility and doctor fees this entire time, but just refuses to pay for the medication. If they won't pay for the treatment, why are they paying for the facility FOR the treatment? Not to mention that we haven't been to the pediatrician's office for 3 months (instead of every two weeks like before).
Anyhow, another 30 days went by and Aetna responded to the second appeal by sending me a letter. This time, their response was that they couldn't process the appeal because Dr. Kumar wasn't "authorized" to act on our daughters' behalf. HE IS THEIR FREAKING DOCTOR! What more authorization do you need?? So, today I faxed the release in so that their own doctor can see their medical information and act on their behalf.
So, we get to keep going back to get the treatments that actually give our kids a reasonable quality of life until Aetna decides to stop jerking us around. I figured up that every trip costs us nearly $100 in gas and food -- not to mention the fact that I have to work over during the week to make up for the day I have to be out of the office. Between the growing financial burden this is putting on us and the added stress of running so hard, it is amazing I haven't completely lost it yet.
Without insurance, the treatments cost roughly $1000 per kid per week -- so $8666 a month or $104,000 per year. I don't make nearly that much, so there is no way I can pay for this treatment let alone afford to live. Sadly, the girls' quality of life rests soundly upon Aetna's shoulders. If they deny the treatments, they are subjecting our girls to a life of infection, sickness, and being socially isolated. Aetna hates their customers, and apparently hates innocent little girls that just want a chance at a normal life, which this medication gives them.
I can't fight Aetna directly, but I can at least put our story out there so that others can see what kind of company they truly are. Far too often, people with similar conditions have the trouble getting the life changing medications they need. IgG is just one that I know of that people have to fight for. It is incomprehensible to me that people have to fight for IgG given the dramatic effects it has on those who need it.
For a point of reference, this picture represents all of the medications that my daughters (2 and 4) were on for the 6 months prior to starting IgG. We have only had to take over the counter allergy meds since.
I ask that you share our story with anyone you can. Hopefully this will help others in the future with similar battles.
This, however, is the proper start of my rant. A little back story if you will....
Our daughters have been fighting infection for the last two years. Serious infections. You get a cold and have pneumonia in three days kind of infections. You have eight ear infections in six months kind of infections. You have to go to infectious disease doctors to get special antibiotics because run-of-the-mill drugs don't cut it anymore kind of infections. You have to take a low dose antibiotic just to try to function in society infections (and still get above mentioned infections).
Throughout this time, Aetna was actually being awesome about things. They were covering the plethora of doctors and specialist visits at the said co-pays and all of the medication. Granted, I incurred nearly $17,000 in out of pocket expenses during those two years, but we were keeping our girls relatively healthy (even though we couldn't really take them out into the public). We were seeing specialist after specialist and doctor after doctor until we finally exhausted all of the resources in Indianapolis. We knew they both have a compromised immune system, but no one could tell us what was wrong or how to actually treat it. So, we just kept submitting all the claims and visits to Aetna and went on our merry way, thinking we were going to have to keep the kids in a bubble their entire lives.
Our infectious disease doctor referred us to a pair of immunology specialists at the Cincinnati Children's hospital, so we made an appointment, packed up the kids and headed out.
About all that we knew for certain about the girls is that their MBL levels were abnormally low or non-existent. This is important because this protein plays a big role in letting your body know there is an infection. Anyhow, after meeting with the new doctor, he said that the MBL was concerning, but shouldn't be causing this (based on other cases he's worked on). Twelve vials of blood from each kid later, we had a large panel of tests to try to figure out what is wrong.
After a few weeks, and after Aetna gladly paid for the facility, doctor's fees, and labs (aside from my co-insurance), we went back to discuss the results. At this point, they were still in the dark, but it is obvious they have something rare and it will take a lot more research. In the mean time, we decided to switch their prophylactic antibiotic to something stronger to help keep of infection. Like clockwork, the girls got sick again on the new antibiotic (our typical cycle was every two weeks). After consulting with Dr. Kumar, he was very concerned that they still got sick, and decided to break out the big guns to try to at least get them healthy while we tried to figure this out. He decided to switch them to Immunoglobulin G.
Our rep at the hospital called Aetna to get things pre-approved and to make sure that the treatment was covered and got the all clear. She called us up after that was settled and made our first appointment to come in. So, on our third trip to Cincinnati from Indianapolis we got our first infusion (sub Q, in the belly). We were simply waiting on Aetna to approve a home health care company to supply us with the meds and pump so we could do it at home. We figured we would have to come back maybe once more before this was taken care of, but little did we know Aetna in reality hates their customers.
We made a fourth trip, then a fifth trip, then found out the bombshell -- Aetna had denied the treatment for the girls. The thing is, after getting these treatments for three weeks, the girls had shown a dramatic improvement. They were playing, and I mean they were playing HARD. They probably never felt this good in their sick little lives, and actually got over a cold on their own WITHOUT any extra medication. This miracle drug had completely changed their quality of life, and Aetna was wanting to take that all away.
Our Doctor filed an appeal on the decision, but wanted to keep treating the girls because it was obviously working. Thankfully, he has the hospital holding the charges on the medication until this gets straightened out. Aetna has up to 30 days to respond to an appeal, so we waited, and kept driving back and forth from Indianapolis to Cincinnati to get life changing treatments for our girls.
After the 30 days had passed, Aetna finally responded -- with another denial stating that they don't cover IgG treatments for what the doctor had said he was treating them for because it was "experimental". Obviously, the experiment worked because our kids were finally able to be kids. He called and talked to the director of Aetna and found that there was a very specific black and white list of what they approved this medication for. The problem is, we don't have a diagnosis yet -- we just know the immune system is involved. So, he worked up a second appeal and drew more labs to get more ammunition.
Keep in mind, Aetna has been happily processing and paying for all of the facility and doctor fees this entire time, but just refuses to pay for the medication. If they won't pay for the treatment, why are they paying for the facility FOR the treatment? Not to mention that we haven't been to the pediatrician's office for 3 months (instead of every two weeks like before).
Anyhow, another 30 days went by and Aetna responded to the second appeal by sending me a letter. This time, their response was that they couldn't process the appeal because Dr. Kumar wasn't "authorized" to act on our daughters' behalf. HE IS THEIR FREAKING DOCTOR! What more authorization do you need?? So, today I faxed the release in so that their own doctor can see their medical information and act on their behalf.
So, we get to keep going back to get the treatments that actually give our kids a reasonable quality of life until Aetna decides to stop jerking us around. I figured up that every trip costs us nearly $100 in gas and food -- not to mention the fact that I have to work over during the week to make up for the day I have to be out of the office. Between the growing financial burden this is putting on us and the added stress of running so hard, it is amazing I haven't completely lost it yet.
Without insurance, the treatments cost roughly $1000 per kid per week -- so $8666 a month or $104,000 per year. I don't make nearly that much, so there is no way I can pay for this treatment let alone afford to live. Sadly, the girls' quality of life rests soundly upon Aetna's shoulders. If they deny the treatments, they are subjecting our girls to a life of infection, sickness, and being socially isolated. Aetna hates their customers, and apparently hates innocent little girls that just want a chance at a normal life, which this medication gives them.
I can't fight Aetna directly, but I can at least put our story out there so that others can see what kind of company they truly are. Far too often, people with similar conditions have the trouble getting the life changing medications they need. IgG is just one that I know of that people have to fight for. It is incomprehensible to me that people have to fight for IgG given the dramatic effects it has on those who need it.
For a point of reference, this picture represents all of the medications that my daughters (2 and 4) were on for the 6 months prior to starting IgG. We have only had to take over the counter allergy meds since.
I ask that you share our story with anyone you can. Hopefully this will help others in the future with similar battles.
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