Medica

My health insurance Medica has made a change in my policy. They placed my MS medicine on a list that they call a "Specialty Med List" and are now telling me I have to start paying $200 a month for my MS medicine that I have always paid (for the past four years) $11 a month for. I had a super fun meeting today with four Medica employees regarding this. Today was my "appeal". I was in the super fun meeting with the panel for 6 minutes. SIX! How much can you really accomplish in that time? Well, I'll tell you. Within that time I told them that I would appreciate it greatly if they would so kindly go back to doing what they always have been doing for the past four years. One woman looked at me and said "well you know this is in your insurance certificate of coverage" And I stated to her that yes, in fact, I was aware that this change it is now in my certificate of coverage and that I was also aware that this appeal is probably one of those rubber stamp deals where they all shake their heads, say they are sorry, but really there is nothing they can do to help me and then promptly deny my appeal. I told them that the problem I have is that Medica just made a change. Someone higher up at Medica decided that my medicine should now be put on a Specialty Med List and therefore I now have to pay $200 a month. Just like that. An arbitrary decision in which I believe another arbitrary decision could be made to (are you ready for this) CHANGE IT BACK! (I know, I know it's a mind blowing concept.)

I've been trying for the past few weeks to make some sense of this. You know to find the greater meaning in it all, because mostly it just feels like I am getting screwed with my pants on.

MS has changed my life and honestly in some pretty good ways. I never want to be thought of as a victim or disadvantaged because truly everyone has something. Everyone has their own personal battles in life, so I don't necessarily want to be looked upon as poor little Becky. Ever. But I would like some consideration from my insurance company that I am --in fact-- a human being and that it would be nice if they could start treating those whom they are in business to serve a little bit better. I find out on Friday if Medica will allow me to go back to the way things were. I am not holding my breath.

I was thinking about my super fun meeting there today before I met with the panel as I sat in the lobby of this insurance giant and looked around at the deep mahogany walls and the sparkling marble floors. I noted the lavish decorations that have been put in place for the holiday season. Dozens of poinsettia's, wreaths of garland tangled with ribbons and glitter. I looked at the thick glass top desk that housed two well dressed, perky girls who cheerfully greeted the folks as they entered the grand waiting area. I tried hard to think and figure out where I fit into this place. What was I really here to accomplish? I know that I've been worked into the actuaries equation. They know exactly how much I will cost them if I fight this change in policy. I've been reduced down to a number that will help them meet a better bottom line. They have figured out that my complaining, my requests for their time for an appeal, that it is still less expensive in the long run to make this policy change. They have probably figured that I'll just stop taking the medicine (which I currently have) and already in two months it's saved them $4000. This drags on longer and next month they will save another $2000. Someone is going to get a new boat at Medica for Christmas at my expense. Meanwhile, I sit and wonder if my MS will hold steady without the medicine. I gamble with my future because of Medica. I don't have an extra $200 a month to pay for the medicine. I just don't. I don't live extravagantly. I am the thrift store queen. I work hard and give back in the line of work I choose to do. A co-worker once said that a civil society is one that takes care of it's people. And I couldn't agree more. I still believe that and work towards that with the employment I choose, but I am beginning to see how those choices are probably making my life harder. I still don't know if I would choose another way. Sell my soul to work for Best Buy? Sure, but only if it's in their corporate giving department.

Today at the end of the super fun six minute meeting I made one last comment. I told the panel that I understood part of the problem they are faced with is making an exception for just me. I understood that they couldn't really do that just for me and I wanted them to know that I couldn't agree more. I want the policy changed back for everyone who's taking MS medicine. I want the "specialty med list" to go away. That this isn't a fight for me alone. That's what I realized today of the role I probably have. Our lives are always bigger than our own imagined personal discomforts. Medica's actuaries actually have made an error in assuming I was the ordinary, or average. I'll make more noise about this, even if I don't want to.. and I don't honestly. I don't want to show my vulnerable side to the world all the time, but in the words of a very special person, sometimes to win a fight you have to start a fight. Healthcare shouldn't be for the privileged and mostly it already is. I'll fight this fight with Medica and I might lose, but it won't be because I gave up or in. So that's why I post this here today. It's about pushing aside the idea that my privacy is more important.

In the past two months I've spoken with the Attorney Generals office, the Department of Health, the Department of Commerce, and just yesterday the Minnesota Disability Law office. I've talked to my executive director of my organization, my doctors, the pharmaceutical company that makes my medicine, my co-workers, my friends, my family, and now the general public by posting this here. I need to step outside what makes me feel uncomfortable and push harder at this already tender spot. I won't tell you that I haven't cried about this. It does make me feel sad and I think that is normal, but that shouldn't stop me from moving forward with what I think is right.