Well - today, I am off to the doctors office for a completely useless visit. This will put money in the hands of my doctor that she doesn't need (nor does she actually want this). This will make my drug insurance company happy. They seem to think that they know more than the doctor who is treating me. I find that absolutely amazing.
My doctor has a now 12-year long association with me. We have worked together on my health issues very well over the past years. I am an intelligent person - especially when it comes to things medical - I do my homework. My doctor has been in practice for at least 20 years. Prior to that she went through 12 years of schooling. And then some since she has TWO specialties. In between all her doctoring - she has raised some lovely children. I have a ton of respect for this lady as a person, as a doctor, and as a mom.
So - can someone explain to me why an INSURANCE company thinks that it knows my needs better than someone like this?
Why does it seem to think that the more expensive drugs (which I'm paying for out of pocket, by the way) - might possibly not be required by me? If they weren't, would it not stand to reason that I would not refill them? We aren't talking about a drug which makes me see things differently - we are talking about nexium - a pharmaceutical used in the treatment of acid reflux or GERDS. A medication that costs me 100$ a month! Thats 100$ that could go towards my sons braces! GOOD GRIEF!
That is the entire point of this visit.
If I were simply refilling any of the other prescriptions, this insurance company wouldn't bat an eyelash if my doctor simply wrote out the prescriptions without an office visit. But since this particular medication is expensive - an expense that is, I reiterate - coming from MY Pocket - not thiers - they would like me to stop taking it. So they are making it as difficult as they can.
Proof to the pudding - last year when we went through this same ridiculous mess, I had just refilled my prescriptions for 90 days. I sent them the new scripts - thinking logically (my mistake!) that they would enter the new ones in their system and leave them there till I requested them. As I said, that would have been logical. No - they entered them into the system ON THE EARLIEST DAY THAT THEY COULD BE SENT OUT (according to the rulebook) and without so much as a by your leave - mailed them. So, now its October and I have a 180 day supply of these pills. Now, you would think they could do math and would perhaps have some inkling that if I have a 6 months supply - its going to be five months MINIMUM before I request them again. No - not them. Since its over 3 months since I ordered the 90 day supply, I must NO LONGER REQUIRE THEM! So, when I call for a refill - it takes them A MONTH to verify with my doctor that I really need them. No only that - they do NOT acknowledge that THEY screwed up - they tell me this is my fault for not ordering when I should have? And furthermore they push out the delivery date so that I have two choices - go to my doctor and get a prescription to tide me over at a local pharmacy (a practice frowned upon by this insurance company) OR pay even MORE money to get the darned thing shipped overnight (which is really 2 days or 3 if one of the 2 days is Sunday!)So far, this company has done NOTHING to endear themselves to me. Apparently - they have pleased the corporate HR GODS who decide what medical insurance NOT to offer. (If its actually good insurance - our company DOES NOT offer it. In fact - to a select area/region of employees - they do not offer a choice at ALL!)
Of course - it would help if the people that I have to talk to at this company actually spoke the same language................ but they don't. Another issue I have - a good subject for a rant (and another post!).
Since writing this initial post, I have taken every prescription I have and figured out what was its generic counterpart which would fall under the 4$ umbrella of a local department store. I also read some considerable medical documentation (do NOT try this at home folks! This worked for me - I do NOT recommend this for anyone else!) and substituted omeprazole - an over-the-counter GERDS medication - for my nexium in the CORRECT quantities. This has saved me considerable money over the past year and my son now has his braces!
