If your medications aren't covered by your insurance, it is serious. For Medicare eligibles, you can get some good tips from the Medicare website, the rest of us are in a tough spot. Never base your decisions on your coverage because insurers are not liable for their "medical" decisions, but DO submit your claims, keep your denials, follow the appeals process and create a good paperwork trail to pursue every other avenue including small claims court based on a breach of contract (depending on what your policy says). But here's a weird one:
I heard this one from a friend. There's a woman in the office who has alleged she has liver cancer. She also alleges that her meds cost upwards of $60,000 a year, and she's asking for help. Others on the job have jumped at the chance to sell Mary Kay cosmetics and donate profits to this woman, raise money for this woman and generally have taken her on as the office charity case. Today, I asked what medication the woman was on that wasn't covered by the insurance plan that not only insures this woman but everyone else in the office? No answer. I then asked what the medication reimbursement plan was at the company, including out of pocket maximums? No answer. Has the woman exhausted appeals to the insurance company? No answer. I finally asked, if you're all in the same boat, and you think that if you get sick you have no coverage, why wouldn't you band together to approach corporate about the insufficiency of your coverage? My friend's no dummy, she knew what I was saying. Listen, we all saw the internet collections for child cancer patients.
There are a lot of good charities out there, ask the right questions: How much of your money goes to the cause and how much to overhead? What aspect of the cause is your money designated for? Have there been issues with accounting? (another way of saying run away from this). In the case of my friend's coworker: Are you getting receipts for your charitable donations? The woman claims there is a fund she has set up with the donations---hmm, really?
Charity collection and business environments really are not ethical. Everything from the United Way to the Christmas gift wrap selling is an outrageous exploitation of people forced to be in a confined space together.
