Thursday, July 29, 2010

Insurance crazyness

Up until now I was insured with my Mum and Dad (two different insurance companies). I always used Mum's insurance company for my enteral nutrition - she has the best insurance company over here in Austria :-).

Due to no longer being a university student I could no longer be insured with my parents. I am not going to start working in the hospital until November and therefore had to find a way of being insured in the meantime. It was decided that I was going to get insured through M's insurance. We do have to pay a lot more for my insurance now, but I can't not be insured... Anyway, M is insured through an insurance company that usually is very picky about paying for enteral food and especially for enteral pump giving sets. This has been worrying me for a long time, as we are not really able to pay for my food out of pocket.

Last Friday I called the insurance about how to arrange my enteral foods delivery, and they put me through to one of their docs. She ended up being really nice, asking me why I needed tube feeding and when I told her why, she immediately agreed that they would pay for my food and my pump feeding sets! She then put me through a guy working in administration because she said that getting my food in Vienna will be a problem. The thing is, M works for a non-profit organization that is located in Salzburg (four hours away from Vienna), and even though he lives here in Vienna his insurance company is the Salzburg branch of the main Austrian insurance company. This insurance company has a deal with all pharmacies in Salzburg that tube feeding formulas and giving sets can be ordered through any pharmacy in Salzburg and picked up there. Well, I can't drive to Salzburg just for picking up my formula.

This is how it has been arranged now:

My dietician faxes my prescription to the insurance company, they approve it and fax it to my old home care company (Fresenius Kabi - I have their food, pump and giving sets) in Graz. My dietician has to send the original (non-faxed prescription) to the home care company as well. My home care company then arranges delivery to me, and sends the faxed approval, the original prescription, and their bill to a pharmacy in Salzburg. This pharmacy then bills my insurance company!
Crazy.....
But it worked! They even approved my semi-elemental tube feeds without any problems.

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