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Finding the right health insurance plan can be overwhelming for anyone. Add type 1 Gaucher disease into the mix, and it can become a bigger challenge. Jade knows from experience.
As a child and young adult, she had been on her parents’ insurance. Later she took whatever her employer was offering. But when she went into business for herself, her insurance was up to her for the first time. She just chose the insurance provider she had as a kid. The name was familiar, and she knew that they covered her Gaucher needs. Other than that, she assumed the companies were all the same. But that couldn’t have been further from the truth. And navigating different insurance options was stressful.
The amount of stress I already have to go through to manage my condition, and the appointments, and the symptoms and all that is hard enough, but then adding in the insurance part made it a nightmare.
After years of frustrating policies, automated messages, and unhelpful responses, she decided it was time to look around. She did research and asked friends and patient groups about their insurance experiences. Then she made the leap, leaving behind the company from her childhood and making an informed, adult choice. What a difference.
“Now when I call, I get to a real person within the first 5 to 10 minutes every single time. With my old company, it would take at least an hour. Plus, the people I’ve spoken to have actually been very empathetic and not totally business."
“The experience has felt very above and beyond. I was on the phone with one person, and she was actually going out of her way trying to give me ideas and was genuinely thoughtful. It’s like night and day.”
For Jade, the time and effort the research took was more than worth it. It’s still an insurance company, so dealing with it isn’t a fun thing to do. But as far as she’s concerned, the worst is over.
Before finding the right fit, Jade ran into a problem with her insurance every single year for almost a decade. There was a yearly renewals process that had to be followed in order for her to continue to access her prescribed treatment. But it was set up in a way that left her without coverage every January and February. The insurance company wouldn’t budge in their timing and requirements.
So I told my Case Manager about my problem and she gave me the magic words: continuation of care. She said I should call the insurance company and make my case again, this time using the phrase ‘continuation of care.’
And when she did just that, the simple phrase unlocked doors. Suddenly, the conversation with her insurance company changed.
Jade had discovered what Case Managers are all too familiar with—insurance companies have their own language. When talking to them, using it may help them understand exactly what you need.