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Bless this bureaucracy

Updated on December 31, 2014

On Saturday, I got an e-mail from the Health Well Foundation saying that my grant had not been used in 45 days; if unused in 90 days, the grant would be cancelled. Since it took me four months to get the grant, I was concerned.

Call 1, to Curascript . This is the pharmacy that provides the Xolair to my doctor for injection. They are supposed to hit my insurance for the amount, then Health Well for the copay.

Me: Health Well tells me that you are no longer billing them; they haven’t seen a bill for 45 days.

Curascript: We show a zero balance on your account. You should check with the Foundation; maybe they missed the bills.

Call 2, to Health Well Foundation.

Me: I spoke to Curascript and they show a zero balance. Could you check your records?

Health Well: We show that the last bill paid was September 28. Nothing since then.

Me: Well, something changed in October. If I find I don’t need it, how do I cancel the grant?

Health Well: Don’t bother; you’re covered until April. We’ll put the funds into general coffers and you just contact us if things change. You need to contact Curascript.

Me: Did that.

Health Well: Then try calling your insurance company.

Call 3, to MVP, my insurance company.

Me: I’m concerned that I will suddenly be hit with a whopping bill. The Foundation says they haven’t been asked for money since September 28, but the pharmacy says I’m all paid up. Did something change in October? This is considered a medical bill, not pharmaceutical.

MVP: Nothing has changed on your coverage. We last paid Curascript on November 18. You should call the Foundation to be sure they are paying the copay.

Me: Did that; they say no bills have come in.

MVP: Then call Curascript and be sure they are not billing the wrong place.

Me: Did that. They are very familiar with the Foundation and say my bills are all paid up. Would you please look up the last payment to Curascript and tell me the date and amount?

MVP: November 18; $3,166.46.

Me: Sounds like the full amount for one month. Could you please look up August and see what you sent to Curascript?

MVP: In August we sent them $2,459.46.

Me: so there’s a decided difference between the two. Did Xolair coverage change in October?

MVP: No, you have no coverage changes until January.

Me: Could this be the Social Security Special Help in action?

MVP: You mean Medicaid is covering the difference?

Me: No – it appears you are covering the entire bill now. Under Special Help, there is no doughnut hole. Once I reach a certain point, there is no more copay.

MVP: Oh, yeah. That’s right. Yes, that could be it, so you wouldn’t be charged any more copays until January first.

Whew! And it only took three calls and my time of an hour and a half, not counting the menu waits and holds, to know everything is fine.

© 2014 Bonnie-Jean Rohner


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