Hola! Si, otra vez, mi segundo encontronazo con el sistema sanitario americano, pero esta vez unido a la maravillosa situacion economica en España y tambien, a uno de los mayores despistes de mi vida. Vamos con la historia...
El sabado mientras hacia limpieza en casa, tire a la basura dos envases vacios de mi medicacion, pero por error, tire el envase que estaba aun lleno, con 80 dosis!! Soy asmatica y tomo diariamente 4 dosis de Symbicort, un corticosteroide broncodilatador. El caso es que me di cuenta de esto cuando por la noche me disponia a tomar mi dosis. Cuando me di cuenta de lo que pasaba, casi me entra un ataque de asma!! Era sabado por la noche, al dia siguiente el centro de salud estaba cerrado y yo estaba perdiendo dosis!!! Intente tranquilizarme, aunque por la noche tuve varios episodios de apnea y el domingo por la mañana, bien tempranito, llame al telefono de Northwestern al que se puede llamar durante el fin de semana o en dias de fiesta.
Despues de dejar mis datos, tuve que esperar unos 20 minutos hasta que un medico volvio a llamar. Le explique el caso y muy amablemente, llamo a la farmacia para que tuviesen preparada mi medicacion. Hasta aqui todo resuelto.
Ahora viene lo mejor, cuando llegue a CVS, me dieron mi inhalador y vi la factura...
274 $
Si!!! Lo que leeis :) un inhalador de 120 dosis, a 4 dosis al dia, eso es para un mes!! Casi me da un ataque de asma alli mismo, jeje! De la "emocion" se me cayo la tarjeta de debito al suelo, jaja! En fin, pague, inhale, me tranquilice y al dia siguiente fui al centro de salud a reclamar el 50% del precio total del medicamento, que es lo que mi seguro de "visitor scholar" me paga. Asi que al menos he recuperado una parte. La otra parte, supuestamente la tiene que pagar la Junta de Comunidades de Castilla - La Mancha, pero eso es un decir, puesto que me han dicho que no lo van a pagar sin darme ninguna explicacion.
La conclusion es que yo pago la seguridad social española y la americana y que desde España me reembolsan la americana, de modo que yo solo pago un seguro medico. Eso es lo que dice mi contrato de la JCCM, pero del dicho al hecho hay un gran trecho y eso es lo que ha pasado. No me han pagado el seguro medico americano y tampoco mi medicacion, con lo que despues de pagar dos seguros medicos de dos paises distintos, yo soy la que pago la medicacion de mi bolsillo. Lo peor es que voy a ir a casa en menos de dos semanas, con lo que podria haber cargado de nuevo con mis inhaladores, pero este era el ultimooooo!!! Dentro del caso fui afortunada. El responsable de los seguros me dijo que al menos habia llamado por telefono y que no habia sido necesario que un medico me viese, si no, hubiese tenido que pagar 250 $ extra por ir al medico en fin de semana, me quedo "topicueta". Bonita historia, pero bueno, considerando el panorama economico actual, no voy a quejarme y me seguire considerando afortunada por tener un trabajo bueno y que me gusta.
Dicho esto y considerandome afortunada, tambien he de decir que el modo de lucrarse con la salud de las personas es algo muy bajo y por desgracia, aqui se hace. La salud no es un negocio y toda lucha por impedir esto es poca. Por suerte una grandisima parte de America apuesta por un cambio en el sistema sanitario, donde hasta ahora, la gente tiene que rezar para no ponerse enferma. De verdad espero que esto evolucione hacia un sistema mas justo y favorecedor y que otros paises, como España, no se dirijan hacia este extremo. Estamos en crisis, pero jugar con la sanidad no es manera de salir de ella.
Hi! This is the second story about my adventures with the American health insurance. This time joined to the wonderful economical situation in Spain and coupled to one of my brilliant performances in life. Let's go to the point...
Last Saturday while I was cleaning our apartment I threw away two empty bottles of my asthma medication. The thing is that one of them wasn't empty, it was pretty full with 80 doses still. I need to take 4 puffs per day and when I realized on Saturday night when I was about to go to bed I almost had an asthma attack...Saturday night, next day Sunday and Monday was memorial day, the health center is closed. I tried to calm down and Sunday, early in the morning I called the phone number for the weekend cases. After giving my data, a doctor called me back 20 minutes later, I explained her the case and she called the pharmacy so I could get my inhaler from there. Everything seemed to be solved, until I arrived to CVS. I took my medicine and then, the big moment, the bill...
274 $
Yes!! 274 $ for a bottle of 120 doses, 4 doses per day, one bottle for one month. I almost had an asthma attack right there. I felt so excited about the bill that I even dropped my credit card because I was kinda "surprised" hehe! I finally paid, inhaled my medicine and on Tuesday I went to the insurance department to claim the 50% of the total cost, which is what my "visitor scholar" insurance pays. I could recover that part at least. The other 50 % was supposed to be paid by the Spanish government, particularly the subdivision of my region "Castilla - La Mancha". Unluckily the told me very kindly without any kind of explanation that they were not going to pay for it. That's not the entire thing, they are supposed to pay my American health insurance since I pay both, the Spanish and the American, but they are not going to pay for that either, even though that is what my contract with them says. The final conclusion is that I pay two health insurances and none of them pays for my medication, that's great!! The worse part is that I'm going home in less than 2 weeks, the perfect chance to bring my almost free medication with me, but of course the bottle I threw away was the last...I can still consider myself lucky. The insurance responsible told me that I was lucky I just called and I didn't have to be attended by a doctor, otherwise I would have paid 250 $ extra for being seen by a doctor during the weekend. That is just amazingly incredible to me!!!!!!!!
That's more or less the story, but considering the hard economical situation Spain is going through, I really consider myself very lucky for having a nice job that I truly like. Having said this, I also need to say that making money from people's health is something terrible and unfortunately this happens in this country. Health is not business and it is really necessary to fight against this kind of system. Luckily there are many Americans trying to change this, since until now, some people must be praying so they don't get sick. I really hope this evolves towards a more fair and better system for everyone, rich and poor and also, that other countries including Spain don't start adopting these ideas due to the hard crisis moments. Yes, we are in a bad moment, but playing with people's health is not the solution!
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