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Just a little insurance whine...

Posted: Sun Nov 08, 2009 5:17 pm
by euphoniaa
...and I don't even expect advice. I'll preface it by saying I know I'm truly fortunate that I have health insurance at all. Good insurance. Affordable insurance - through my job. I feel pretty guilty for complaining about it at all, but dammit, they finally dx'd a medical condition in my poor, pitiful legs that can be fixed (hallelujah!)...but insurance refuses to cover it. Geez!!

I've had this giant varicose vein in my right calf (my non-MS one) ever since I chipped my knee in high school and had my leg in a cast for 6 weeks. Last summer it started aching in yoga class, so I went to a vascular surgeon, who declared it was the kind that's easily fixable by a simple laser ablation. Something fixable!!! In me!! Something that's not demyelinating, deteriorating, degenerating, or steadily progressing! That knee has degenerative joint disease & swells up like a cantaloupe, the other leg has foot drop, RLS, twitches, tremors, and spasms. But this vein can be fixed!

However, insurance declares the procedure cosmetic, and not necessary. They will reconsider if my body's still wracked with pain after wearing super thick support hose for 6 weeks. I explained to the nurse how difficult it would be for me to wear thick, heavy stockings due to my peripheral neuropathy. I can barely wear socks and heavy shoes for short periods, and wear skirts, hose, and thin dress shoes most every day at work to avoid the burning (no, that's NOT from MS). But I admitted to her that the vein pain is usually not that severe even now, (except this evening, for some reason).

But...it's fixable! I think it would be worth it just for the psychological boost. And the company's getting off pretty easy in my case. They're saving thousands of dollars every year because I don't take expensive MS meds. And I shrug off the offer of an annual MRI from my neuro, because it wouldn't affect my treatment choices anyway. And they don't offer a cent for my REAL treatment – diet and exercise. I think they should at least be covering my health club membership and let me use my insurance card at the grocery for fresh fruits & veggies. They didn't even pay for my fabulous canes, since they're expensive, non-medical-looking ones (I, of course, insist on using canes with a bit of an "attitude" :) ).

Well, now I feel better. Sending good "attitudes" to you all. :)

Posted: Sun Nov 08, 2009 6:11 pm
by jimmylegs
sorry you have to deal with this e.

here is a quick collection of abstracts which may or may not help you to construct an argument... if you choose to argue!

http://jrsm.rsmjournals.com/cgi/reprint/99/11/589.pdf
http://www.springerlink.com/content/9118w235j3441230/
http://www.ingentaconnect.com/content/b ... 4/art00004
http://www.neurology.org/cgi/content/abstract/55/9/1341
(the last one needs a ful-text search; varicose not in abstract - see google search for: varicose veins "multiple sclerosis")
HTH,
JL

Posted: Mon Nov 09, 2009 4:26 am
by euphoniaa
Thanks, JL. I'll take some more time looking them over when I can reach another computer - mine's been really acting up lately. I was hoping I could convince someone in the office to pursue it more with the insurance company - adding additional info - but my explanations didn't seem to help.

A couple more notes, though:

My varicose vein is limited to one single spot, and a direct result of 6 weeks of pressure on it from the way I had to prop it up in the full-leg cast. No matter what relation venous issues have to MS, this one is probably not.

I have no edema whatsoever. Even when my knee swells, it's totally confined to that joint. It's only happened about 3 times - the 1st time it went away when they taped my kneecap back into place for awhile. :)

I made an attempt to bring up CCSVI to my doc last summer - he gave me a minute or two and then dismissed it with a, "Never heard of it." I was hoping something new would have appeared in his journals by the time I got the procedure done and I could get his take on it. The nurse said I can mail something to his office if I want.

Right now I'm only concerned with my legs, though. And now I'm off for another long day. Thanks for the info!

Posted: Mon Nov 09, 2009 11:54 am
by LoveActually
e,

I'm sorry for your troubles. I've been on the phone with my insurance company for the last week, setting up a case manager and all that stuff. They told me they wouldn't pay for supplements or any foods unless prescribed by my doc. Bummer! But anything prescribed, covered!

I'm thinking about hitting him up for a treadmill prescription. :) But really, I wonder if your insurance works the same way. We've also been talking with our tax attorney about write offs. Any medical equipment, like your cane for example, you should be able to write off. And prescribed drugs, write off!

Good luck! I too am very thankful to have such great insurance, especially after seeing my Copaxone bill.

P.S. I'd love to see your cane.

Posted: Tue Nov 10, 2009 5:24 am
by euphoniaa
LoveActually wrote:e,

I'm sorry for your troubles. I've been on the phone with my insurance company for the last week, setting up a case manager and all that stuff. They told me they wouldn't pay for supplements or any foods unless prescribed by my doc. Bummer! But anything prescribed, covered!

I'm thinking about hitting him up for a treadmill prescription. :) But really, I wonder if your insurance works the same way. We've also been talking with our tax attorney about write offs. Any medical equipment, like your cane for example, you should be able to write off. And prescribed drugs, write off!

Good luck! I too am very thankful to have such great insurance, especially after seeing my Copaxone bill.

P.S. I'd love to see your cane.
Thanks, LA, good luck on your own insurance adventures.

I've never even been close to having enough to itemize on my tax return, and I don't use any meds at all for MS. :) I do have a "Flex" plan I pay into at work that gives me a tax break on the total amount of med expenses I'm stuck with and over-the-counter stuff. Even that doesn't go to $1000, but it is out of my own pocket. I'm VERY fortunate, though. :)

But that's one of the reasons that patients go straight to prescription meds - nothing mild like OTC meds or even supplements is covered. Of course, I've had a few reactions to supplements/vitamins that are worse than anything MS has ever hit me with. I just paid $20 (out of pocket) over the weekend to try EGCG and I'm already trying to figure out how to take it without it making me sick. My Supplement Story is actually a Long Sad Saga, which I won't go into here. My body is especially resistant to anything that's deemed to be "good" for MS. Like Omega 3's... Or even vitamin D. Yikes. 8O

My barley twist cane - and my new hiking stick - are from here. http://www.bestofnewengland.com/canes_Hiking_Sticks.htm

I'm sure the style wouldn't appeal to everyone, but it gets a lot of compliments and, when I present it along with a big smile, puts people at ease and brings me a smile in return. But...it's so nice that I'm on my 3rd one due to getting them swiped out of grocery carts. I'll forget it for 5 minutes, and then when I return, it's gone. I never take it into any store with a cart any more, I just hang on to the cart handle.

Good thoughts and smiles to everyone today.