Sunday, November 14, 2010

Clowns to the left of me, jokers to the right

Well, I don't know why I came here tonight

I got a feelin' that something ain't right

I'm so scared in case I fall off my chair

And I'm wonderin' how I'll get down those stairs

Clowns to left of me, jokers to the right

Here am I stuck in the middle with you

Yes, I'm stuck in the middle with you

And I'm wonderin' what it is I should do

It's so hard to keep this smile from my face

Losin' control, I'm all over the place

Clowns to left of me, jokers to the right

Here am I stuck in the middle with you

All the signs were there, but I tried to ignore them.  The warm days of summer turned blustery, the school buses suddenly appeared, the leaves turned colors, and the radio started to play songs about a big jolly man in a funny red suit.  Yes, it's Open Enrollment season.  

Open Enrollment is that special time of year when companies give their employees the opportunity to make health care choices for the upcoming year.  It's also the time of year you receive finely wrapped packages filled with numerous full color brochures all with the same two messages.  The cost of health care has increased again and the options are more confusing then ever so good luck!

Don't get me wrong.  My company does a nice job informing employees through a mix of brochures, websites, internal meetings and help lines.  However, they don't quite have the system optimized for those of us with "special" insurance needs so it takes a bit more expertise to navigate through the information.  Last year at this time we still had not received Maddie's diagnosis, but knew something was up, so we played it cautious and chose a plan that came with platinum frequent flyer status.  

All in all it worked well, but I wanted to make sure it was still the best deal moving forward.  As there were a couple new options this year I called our company support desk and asked them all the usual questions about deductibles, coverage, and doctor choices.  The operator did such a great job answering the usual questions I thought it was safe to throw her a curve ball.  I don't like to advertise the complexity and cost of the girls' treatments within my company so it went something like this. "Let's say someone had to get infusion therapy once in a while and it was expensive...say $10,000 each time.  Would that be covered?"  The response was, "Well, that's interesting.  Let me see.  Perhaps you should call the insurance company directly."  

I was hoping to avoid this, but picked up the phone and called the insurance company anyway.  After weaving through layer after layer of the automated answering system I finally made it to a real person.  I exchanged a few niceties and launched into my question as clear and detailed as possible.  Suddenly, the real person began to speak through some kind of automated voice machine.  "Thank you for calling XYZ Insurance.  Our ABC and DEF plans offer competitive coverage and the best service to our customers."  Hello?  Is there a real person there?  Hello?  She started again, "Thank you for calling XYZ ..."  I hung up.

So there I sat with clowns to left of me and jokers to the right.  Stuck in the middle.  And then I remembered to call Lynda.  Genzyme has a Care Coordination program, which assigns a Case Manager to each family receiving one of its therapies.  Ours is Lynda.  She has been a great help over the past months as we meandered our way through the maze of hospitals, insurance coverage and payments.  After one short discussion with Lynda, she called the insurance company, confirmed our coverage, identified the options, and helped me with the decision.  Once again Genzyme proved they are different.  When you feel alone, they are there to support.  When you need advice, their experts are ready to help.  And, when all you find are clowns to left of you and jokers to the right, you are happy they are stuck in the middle with you.

Thanks again to Lynda and the whole team at Genzyme!

Credit: Stealer's Wheel, "Stuck In The Middle With You"