Frustrations and a lot of rambling

I am so frustrated with my insurance company.  I have Panhypopituitarism/Sheehan's. I hate being know by a diagnosis, but it helps me explain it better.  Basically this mean my pituitary gland doesn't work.  It is damaged and it runs at around 5% on a good day.

Five years ago I finally found a doctor who ran the right tests and diagnosed me with  my diagnosis.   There are several different ways you can treat this  and I tried all the least evasive ways,  but they weren't enough.  Then, my doctor started me on HGH (growth hormones injections) and once I was put on the right dose life improved immensely. 

My old insurance company paid for my prescription starting in the spring of 2008 until my husband lost his job at the beginning of this year.  In  April we started with our new insurance company and I have been fighting for them to cover my needed prescription. Once I started appealing it, many  representatives from my insurance company blamed it on  the increasing cost on the middle class from Obamacare.  They claim because their costs are rising that often their insurance company will delay coverage, or create so many obstacles that most people will give up.Or when a prescription/procedure is too expensive they create many loop holes. Each time I hear it,  I just want to cringe.  Obamacare isn't even in full gear yet and they are blaming it on it.

  The pituitary is responsible for the pineal, hypothalamus, thyroid, parathyroids, thymus, adrenals, pancreas. and ovaries. 


On Thursday, November 29th I got their final  letter back saying they denied coverage and would not take another appeal.  Then I had a pity party.

They claim the reason they denied coverage is because I need stimulation testing to  guarantee my diagnosis is correct.  Here is the huge Catch 22,  Stimulation testing can only be done as a preliminary test, not 5 years after the diagnosis.   So in order to do the test they require, I have to go off all prescriptions to treat my Panhypopituitarism for a minimum of 6  months.  The reason I didn't have this test in 2008, is because  the only diagnosis required  then was to fail an IGF-1  and show the absence of the  hormones the pituitary makes.  Being off my shot is not very safe and can be dangerous. Once on this medication it is a lifelong commitment.  Failure to go off of it is similar to a diabetic choosing to go off their meds, when they still need their medication.  

The other problem is there is no doctor in Utah that does stimulation testing.  The closest doctor is at UCLA in CA.  Stem cell stimulation testing is very evasive, expensive, time consuming and painful.

I have  been calling the drug companies that  makes it, but it takes several months to go through their process to try and get them to cover it, and of course you have meet their financial requirements. Just so you understand the problem, if I take the full dose of this prescription like I have taken for the last five years, it costs around $1500  a month. Just taking the smallest dose possible,  is even too expensive for us.

I have learned if Matt would quit his job that we would qualify for assistance. Of course, Matt isn't the type of person to want to do this.

  I keep telling myself for some reason I need to have this trial in life so I can learn a lesson.  So I keep trying to figure out what I am supposed to learn.   One thing I have learned from having any kind of  health problems is  to have a lot more compassion for the struggles that others face.  Maybe I just keep needing to learn this lesson.  One thing I have learned is I have a very amazing husband who is very patient with me through this whole process.  I. think. I. already. feel. better. just. by writing. this. At, least that is what I will tell myself.