Baby It's Cold Outside

I can take it pretty well until it gets to freezing. Below freezing is just brutal to me, and I move quickly from one warm space to another and spend zero time enjoying the scenery. This morning it is 16-degrees. Brrrrrrr.

I left Aetna alone yesterday. I'm politely waiting for someone to get back to me in the next 72-hours, for the third time.

I whine and complain enough, but I must say that the programs set-up by Bayer Pharmaceuticals to interface with patients is outstanding. Despite Aetna's blunders and constant ineptitude, Bayer quickly found a way to get me the chemo drugs through their patient assistance program. Bayer developed Operation Outreach and very well-trained individuals stay in touch with me once a month to see how I'm doing, to see if I'm having any problems with side effects, to see if I'm ready for a refill.

They're very professional and very effective. I'll gladly give credit where credit is due.

Meanwhile Aetna never, ever contacts me about anything except my monthly bill, which arrives about two-days before it's due every month. When I call them it's a guarantee of at least 15-minutes on hold, and having to confirm my personal information 17 different times, sometimes to automated recordings, sometimes to actual people. There is also a 25-percent chance that your call will be dropped at some point, usually my a confused CSR who asks you to hold, and then just hangs-up.

I should mention that I have an individual policy rather than a group policy. I was self-employed and an Individual Policy is the only choice. For some reason our government, through HIPPA statutes, ensured logical, common sense rights for individuals - but only in group policies.

For example, no one can be denied health insurance through a group plan. But they can be denied coverage through an individual plan. Hmmmmmm. What am I missing here? Why?

The more I learn the more I'm left scratching my head.

But life is a constant mix of good and bad. As I contemplated my business with Aetna yesterday the phone rang.

It was Operation Outreach, checking in. We discussed the usual, how I'm doing, if I'm on the same dosage of the medicine, if I had any concerns. I did mention my concern over what happens on March 23rd when our current agreement ends.

She saw right through me and immediately told me I had nothing to be nervous about, they would not let me go without the chemo drugs whatever the situation.

WHEW! Boy did I need that right about then.

Come February 22nd I will reapply for the program and they will reanalyze my standing. And hopefully things will work out for another year agreement for me to receive the drug.

But man was it good to work with a professional interested in positive outcomes, not positive cash-flows.