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Living with Diabetes

Working with your insurance company for better outcomes

9/14/2018 by Alicia Downs

Working with your insurance company for better outcomes

I always had an odd take on the movie The Wizard of Oz. I never understood when Glenda just sat on her pink bubble all day instead of doing something about a very serious wicked witch problem.

And I never understood why an entire town had a choreographed dance number prepared just in case someone should happen to show up and ask for directions. I guess I've always been more of a "fight my way in, save the day, knights and dragons action movie" kind of kid. Which is ironic, because I now find myself in a very real fight for my life in which I feel much more like Dorothy in Oz than any action star. There are a lot of moments that unite people living with diabetes. But by far one of the most challenging experiences is having your insurance company deny coverage for a prescribed medication or service. We have been spun from our normal life with Auntie Em and dropped into the Technicolor haze of diabetes. We have trod the long path of doctors appointments, researching medications and options along the yellow brick road. Finally, we reach the Emerald city of a medication or treatment that can really help us! Only to be stopped at the door and told that it will not be covered! 
Often, like Dorothy at the gates of Oz, we get an abrupt "NO" and the door slammed in our face. The Wizard will not be disturbed! But wait, this person at the door doesn’t know us, or our needs! SO how does Dorothy get in? She has the ruby slippers!
What now? Reach out directly to your insurance provider. You can go directly to their website or contact their customer service team. Many insurance plans will have a path to obtain authorization for your medications, devices or supplies. They may also have other unique programs and support services that enable the use of products that aren't on their preferred lists. The teams and medical staff at insurance companies have to be knowledgeable in a wide range of topics and may need to work more closely with your care provider to better understand your specific needs. It may require some extra time and effort, but it may all be worth it to you in the end. Like Dorothy, getting what we need is not a simple task, it's a journey and we have to bring the right information to bear at the right times to keep moving forward. Are you with an insurance company? Come and work with us to ease the frustration of your customers.

Alicia Downs

As mySugr’s very own certified diabetes educator (CDE), Alicia’s diverse nursing career has given her experience with a broad range of clients and a variety of health conditions in addition to diabetes. She’s a fierce advocate for the needs of her patients, whether it be in overcoming insurance restrictions, obtaining community resources, or coordinating with school systems and medical providers.

When not helping others, she can be found acting on stage, singing with local bands and creating award-winning steampunk and cosplay designs for herself and her family.

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