Thursday, July 31, 2008

I HATE insurance companies!!!!

For laypersons reading this blog (no that doesn't mean you get laid a lot - it means you're not in healthcare...), you probably have no idea just how much we pharmacists and techs go through with insurances on a daily basis. Yeah, you may hear a bit of our difficulties when we tell you your prescription is no longer on the formulary, but we deal with that kind of inconvenience hundreds of times every day! The damned insurance companies can do whatever they want, with no notice to us or you, the insurance holders, whenever they want.
Last month your copay was $25? Well, this month it's $50. Or this month, that drug isn't covered at all. Last month the ID number we submitted was correct, this month it's not, and they didn't bother to send you a new card.
Last month, if your insurance wanted prior authorization to cover your prescription (insurance speak for 'we want to know why this person has to have this expensive drug instead of a cheaper one that will do the same thing') we would fax the doctor with the alternative drugs that are covered - if the insurance is kind enough to tell us what those options are - and a phone number to call if they want to keep you on the same med. This month, they expect me to call them directly (and if the doctor does, they won't help the doc, but instead tells them to have me call), then ask me all kinds of questions the doctor has the answers to and I don't. What is the diagnosis, what drugs have been tried and failed, yadayadayada...
Last month, if I submitted a claim for $25, I might have gotten $20 from the insurance company (and your copay would be $5). This month, I submit the same $25 and get only $13 from the insurance company - but your copay stays the same, so I lose money.
Why am I ranting about this? My doctor's office got tired of the crap from my insurance company, and cancelled the contract with them (the insurance wanted to reduce reimbursements by 7% - with inflation higher than it's been in decades, that's a HUGE cut). Now, I'm mid-treatment, and facing the prospect of surgery with little or no coverage from my insurance. Luckily, the office said I still can see the doctor for 60 days, and I also have coverage under my hubby's insurance. But this just pushed me over the edge...
I've said for a long time that insurances are the thorn in my side, but now I'm thinking that it's more like the knife in my back...

4 comments:

fsulass said...

surfing blogs and found yours. I feel your pain. I'm a healthcare analyst at a hospital and it seems like we are always in a constant battle with insurance companies.

Your Blonde CPhT said...

I understand, I mentioned you and that I feel your pain in my blog!!! Keep up the great stuff girl!

*Blonde CPhT

Lipstick said...

Great post. I also hate how insurance cards are not standardized, and a close second is insurance companies who have separate cards for medical benefits and rx benefits. oh course, the pts never know.

BTW, I hope you don't have to have surgery.

Lucie said...

I feel your pain when reading your blog. I suggest that find a insurance companies that will help you. We know that having health insurance is really important for our health.
blue cross of california