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I hate health insurance companies

I don't understand them. I get a letter yesterday saying they won't cover 1 of the meds that keeps me out of the hospital. They said have the doc change it to a covered med. then they tell me that if I get a note from the doc saying its medical necessary. That's all good but the med isn't something I can just grab at any pharmacy. It gets delivered once a week. That once a week happens to be on Friday. Delivery driver just left. I really hope someone gets this figured out real fast.

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    BigshizzaBigshizza Posts: 15,645 ✭✭✭✭✭
    It's not good, the insurance companies dictate what the doctor can prescribe. So many games played that effect people's lives, just not right. Hope it gets straightened out Steve.
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    macs-smokesmacs-smokes Posts: 587
    Sounds like SNAFU is still the norm with them Preventative care is not needed. I have however found that when you call and politely ask for a supervisor and then say you need a decision maker things change. I have had them fix billing errors in minutes vs the years it can take. Thoughts and options are all I've got other than a shared scorn for these types of policies.
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    StsepasStsepas Posts: 475
    Thx Jim. Just doesn't make sense. When you look at dollars and cents. The med is very in-expensive especially compared to the thousands of $ a day to be in the hospital. If I had to I'd surely pay for it out of pocket to avoid being in the hospital. Had I known soon enough I'd have talked to the billing dept at the pharmacy and he'd them send a bill. Now the doc, pharmacy, and myself are playing phone tag to get it straightened out, and tryin to figure out how they'll get it to me. It may very well mean an 1 1/2 hr drive north into the mtns on Friday afternoon to get what I need. Ughh un necessary non sense!!
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    StsepasStsepas Posts: 475
    macs-smokes:
    Sounds like SNAFU is still the norm with them Preventative care is not needed. I have however found that when you call and politely ask for a supervisor and then say you need a decision maker things change. I have had them fix billing errors in minutes vs the years it can take. Thoughts and options are all I've got other than a shared scorn for these types of policies.
    I've been talking back and forth with the pharmacy the pharmacist was very unhappy with the insurance co. He called an expidited delivery service. Filled the script and sent it with no worries of payment. He did confirm with my doctor that it is medically neccasarry. My doctor said he will make sure the ins company approves the med. so glad it got handled
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    BigshizzaBigshizza Posts: 15,645 ✭✭✭✭✭
    Stsepas:
    macs-smokes:
    Sounds like SNAFU is still the norm with them Preventative care is not needed. I have however found that when you call and politely ask for a supervisor and then say you need a decision maker things change. I have had them fix billing errors in minutes vs the years it can take. Thoughts and options are all I've got other than a shared scorn for these types of policies.
    I've been talking back and forth with the pharmacy the pharmacist was very unhappy with the insurance co. He called an expidited delivery service. Filled the script and sent it with no worries of payment. He did confirm with my doctor that it is medically neccasarry. My doctor said he will make sure the ins company approves the med. so glad it got handled
    Great! I'd get that pharmacist some cigars!!
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    StsepasStsepas Posts: 475
    Bigshizza:
    Stsepas:
    macs-smokes:
    Sounds like SNAFU is still the norm with them Preventative care is not needed. I have however found that when you call and politely ask for a supervisor and then say you need a decision maker things change. I have had them fix billing errors in minutes vs the years it can take. Thoughts and options are all I've got other than a shared scorn for these types of policies.
    I've been talking back and forth with the pharmacy the pharmacist was very unhappy with the insurance co. He called an expidited delivery service. Filled the script and sent it with no worries of payment. He did confirm with my doctor that it is medically neccasarry. My doctor said he will make sure the ins company approves the med. so glad it got handled
    Great! I'd get that pharmacist some cigars!!
    Hahaha I'll package it up in 1 of the styrophoam coolers that they send the meds in, and send em with the driver on there return run!!!
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    phobicsquirrelphobicsquirrel Posts: 7,347 ✭✭✭
    ...but.... but the gov'mit is going to tell your doctor what to do, not some private company ... sheesh. Insurance companies are just looking out for ya. I mean what does your doctor know?

    seriously though, these insurance companies should be on notice. Several states are already seeing huge drops in costs thanks to the ACA and sometime in the near future we may see the end of this vulture practice.
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    StsepasStsepas Posts: 475
    phobicsquirrel:
    ...but.... but the gov'mit is going to tell your doctor what to do, not some private company ... sheesh. Insurance companies are just looking out for ya. I mean what does your doctor know?

    seriously though, these insurance companies should be on notice. Several states are already seeing huge drops in costs thanks to the ACA and sometime in the near future we may see the end of this vulture practice.
    I have Medicare to boot so ya the govt is very much involved!
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    Insurance companies has their own rules and mostly it is for the advantage of the company. Almost the same thing happened to me years ago but there's nothing I can do but to pay out of the pocket for the meds. Hope your concern will be solved soon.
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