Monday, April 4, 2011

Health Care Challenges

Many days it takes a forklift of will to get out of bed, let alone run errands. Today I went to the pharmacy to get a refill of one medication and drop off a prescription to increase the dose of another medication. Instead of simply dropping of the prescription, waiting 20 minutes and leaving with both of my meds, it took me an hour and I only got one of them.

My health insurance sucks, and I'm sure I'm not the only one with this problem. For some reason, if my doctor wants to increase the dose of one of my medications, it takes an arm, a leg and my unborn first child to get the damn medication. As if my life wasn't hard enough, my insurance has started requiring pre-approvals from the doctor anytime I need to increase medication.

Why the hell can the health insurance companies do this to us? The doctor wrote the prescription. That should be good enough. Why does the doctor then have to call up to the insurance company to say "Yes, that's what I wrote the prescription for" so that I can get my medication?

Well, it's not that they won't let me get it. They just won't pay for it. The health insurance company wanted me to pay $50 for 31 pills today, and then pay another $50 dollars for another 31 pills in 3 weeks when I run out. (I need 45 pills a month, not 31) Thankfully, I'm smart enough to know that if I wait a day or two for my doctor to send the pre-approval, then I can pay $50 and get all 45 pills.

Are there people out there that just roll over and do what the insurance company says? In this example, if I get my pre-approval through, I end up paying $600 a year for my prescription. If I did what the insurance company wanted me to do, I would end up paying around $913 for the year. Gee, I wonder why they want to give me a hard time?

But in all seriousness, I lost it at the pharmacy. In the back of my head I wanted to say "they increased my medication because I almost killed myself the other week. Just figure it the heck out and give it to me!" Of course, I bit my tongue because the sweet lady at the counter had nothing to do it.

In the end, I'm sure it will all work out. My doctor is great and I'm sure she'll get this straightened out. Plus, as my girlfriend pointed out, now I know to automatically ask my doctor to send in a pre-approval when she increases my medication.  But, I'm still not thrilled with my health insurance company. Maybe I'll let my HR department know how many problems they've given me over the past year and see if they can give us the option of signing up with another health care provider next year.

1 comment:

  1. I understand far more than you could ever know. In fact, the run around with the insurance company is the reason I stopped going to my therapist. I couldn't afford to pay out of pocket and she was so tired of having to resubmit bills multiple times before MAYBE being reimbursed that I figured it would be easier to break up with her than for her to break up with me. For someone with depression, finding someone you can trust is hard enough without the insurance companies making it impossible to see them!