My daughter takes a very expensive medication – like $500 a month. When she got her own insurance, the company refused to pay for it. Their logic was that there were less expensive drugs out there that she could try. They told her that for them to pay for this expensive drug then she would have to try these less expensive options.
This sounds reasonable except that this will make the third time she went through the process. The first time was when the doctor initially prescribed the meds for her. The second time was when I switched insurance companies (to the same one she has now). It is in her records that she has done this before but they were insistent.
Since she can’t afford the drug without insurance, she had to jump through the hoops they demanded. The first drug – did nothing. The subsequent three drugs she had allergic reactions to. The first allergic reaction she had a hard time breathing and broke out in hives. The other two she broke out in hives. At one point the pharmacy didn’t want to give her a prescription because she had an allergic reaction to one of the other drugs.
I made her call me and talk to me while she took one of the prescriptions because I was worried she would stop breathing and not have anyone there to help her.
It is ridiculous that the insurance company had any say in which prescription the doctor gave to her. She has been on this medication for ten plus years and it works. Why mess with that? Especially when she had already tried other medications that didn’t work or that she was allergic to – this seems wasteful as she now has four prescriptions she has to discard because they didn’t work. It isn’t saving money if she can’t use them.
It is ridiculous to change a person’s medication when what they are taking is working successfully. Isn’t that the point of taking medication – finding what works and sticking to it? I know it is a lot of money but that is something to take up with the pharmaceutical company not the patient – especially when there was documentation that other medication hadn’t worked.
Well my morning has been interesting. I’ve not accomplished a lot. I was rudely woken up by my daughter complaining about my husband. She made up for it nicely by making breakfast. Then they went off to Walmart and I was going to take a shower but they kept bugging me with calls. So I waited till they were home.
I worked on some insurance stuff – gotta love insurance. I have to send in my receipts for over the counter drugs now with a prescription from my doctor to get reimbursed for them. Now don’t think I’m getting paid – this is money that is deducted from my pay check for this purpose. I used to be able to go to the pharmacy and buy what was needed using the card from the insurance company. Now however I have to buy it, save the receipt, have a prescription from my doctor. When I have all of that I get to mail, fax, or email it in to the insurance company so they can reimburse me. I don’t think anyone is happy about the process. I know the insurance company wasn’t when I called to talk to them about it.
Now that I have that stuff done, I have to figure out something for lunch. After lunch who knows what mischief I’ll get up to. Maybe I’ll take a nap. Maybe I’ll work on genealogy. Maybe I’ll write. Such wildness on my part I know. This is just another Sunday though and thankfully I think it will be a quiet one.
This weekend Ken and I were out running errands. One of them was to go to the pharmacy to pick up allergy meds and ibuprofen. I have a plan that is supposed to cover these types of items. Ken got up to the counter to pay with my card for my flex plan and it didn’t cover them. He came to the car grumbling about it.
I went home and looked on the website. Sure enough – over the counter drugs are no longer covered. One thing I found covered that I thought was interesting though was Viagra and condoms. They can cover stuff for men to have sex but they can’t cover stuff to deal with my allergies, headaches and arthritis pain.
It seems a bit strange to me that men’s sexual enhancement items can be covered but items that help me breath can’t be. How is this logical? So apparently the flex plan is encouraging men to have lots of sex (albeit protected sex) but isn’t willing to allow others to breath and get rid of pain.
Apparently the flex plan thinks sex is much more important than over the counter drugs. I don’t happen to agree…