"Because we're the insurance company, that's why!"

I recall a meeting at a previous job, where our medical insurance rep stood before us and declared with a straight face, "we care about you and your health. You're important to us!" I immediately raised my hand and asked her if she was representing a for-profit or a non-profit organisation. She replied, "well, of course we are a for-profit company." To that, I responded, "then what you as an organisation really care about is the bottom line for your investors, but please continue."

I got into a little trouble for sassing back like that, but I felt it needed to be done. This took place years before I was diagnosed with Multiple Myeloma and actually needed them to give a real damn about my health. Still, I wanted them to be a little more concerned about covering my health needs over their investors' financial gains.

So previously, I wrote about needing a new infusion in order to boost my immune system. I got a call from the insurance company yesterday--"just calling to check if you needed anything from us and our support group." I told the nurse on the other end of the line that I thought she might've been calling about that infusion. She was surprised to hear about this and proceeded to look into the matter. In doing so, she discovered that (and it should come as no surprise to anyone) the request had been denied!

Yes! The pencil pushers at United Health Care felt that there wasn't enough evidence to recommend approval on this request. Really? Let's do a quick look into why my doctor thought I might need this:

• MPA IgG Serum = 283 mg/dL (acceptable low end 717 / high end 1,411)
• MPA IgA Serum = 8 mg/dL (acceptable low end 78 / high end 391)
• MPA IgM Serum = 6 mg/dL (acceptable low end 53 / high end 334)

Since none of us are physicians, I don't think we can spot anything obvious in those numbers that would suggest that there is anything wrong with me. 

That's sarcasm. I hope you picked up on that because clearly none of us are as wise or as smart as those folks at my insurance company. You're welcome. 

What do we do? Apparently, my doctor needs to have a peer-to-peer conversation with one of their doctors. That should go swimmingly because it their doctor had a head, he or she could easily see exactly why this infusion was recommended. And I really don't think my doctor (or any reputable doctor) would recommend such an aggressive therapy to help his or her patient unless the patient really needed it. Perhaps it would help the braintrust at United Health Care if my file were just marked "INCURABLE / TREATABLE" so they understood the severity of my situation and they could be spared hours of head scratching.

This is so exciting!

And now we wait...