Friday, November 16, 2012

Infinite Loop

On October 12th, I dropped two packages in the mail.

One headed off to Canada Revenue Agency and contained my application for the Disability Tax Credit.

The other headed to my health insurance company and contained an application to have continuous glucose monitor sensors covered.

I have not yet heard about the Disability Tax Credit and don't expect to hear for a few more weeks at least.

I did hear back from my insurance company.

Before I tell you their response, I will explain the process I had to go through.

1. I called them to ask if continuous glucose monitor sensors are covered. They said no.

2. They then explained that, if something is not covered, I could complete an application form and submit a quote from my pharmacy for the cost. They would then decide whether or not to cover it.

3. They would review that application and let me know within 7 business days of their decision.

Make sense?

Here is what happened.

1. I completed the application, obtained a quote from my pharmacist AND wrote a very lovely cover letter to explain the need for CGM sensors.

2. I mailed it in on October 12th.

3. I waited 12 business days (which is way more than 7) and then called them. They said that they had received my application and had no idea why it would take so long to decide. The promised that I would hear back within a few days.

4. Seven days later I received a letter in the mail that stated: we are unable to accept your claim because your contract does not cover this type of appliance / service.

Well no kidding folks.

We all knew after the original phone call a month ago that my contract doesn't cover it. That's why you told me to complete the application to have it covered.

They don't cover it - they tell me to apply to have it covered - they tell me that they won't cover it because they don't cover it.

Insert never-ending loop infinity and beyond!

So of course I will be calling them to find out if there is a better explanation than that and to find out what the next step might be in the appeal process.

The story does not end here and I will certainly keep you posted.


  1. Ah, the circumlocution office...

  2. Ahhhh, that loop? I hate that loop! Good luck.

  3. Oh, gawd ... that's EXACTLY the kafkaesque universe I ended up in with Blue Cross. I eventually got someone to say that the insurer will cover anything the *employer* asks to have covered — provided, of course, it gets paid for, through extended health premiums. At that point, I began a long, tedious, and ultimately fruitless exchange with HR at work (a community college). I don't know if they ever did get to the point of asking Blue Cross how much it would cost to have CGM sensors covered ... I was sufficiently frustrated with Medtronic's CGM glitchiness and all the coverage barriers that I just gave up!

    I do believe that, eventually, these things *will* be covered in the way test strips are. But it's going to take a lot of persistent battles and individual victories before that becomes the norm. I hope you will have one of those pioneering victories, Céline!