Health insurance, ugh!

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 I drove over to Dr. W’s office yesterday to pick up some free samples of the medication he prescribes for me.  I’ve been taking this medication for a minor medical issue for about 2 1/2 years now

So why didn’t I just call the pharmacy and order a refill?

Actually, I tried to get a refill.

My insurance company wouldn’t authorize it.  Seems they no longer cover that particular medication.  One they approved 2 1/2 years ago.

I started seeing Dr. W about 8 years ago.  He prescribed a medication I will call Pill A.  This medication worked for me.

Then in March 2020, I changed jobs, and therefore also changed health insurers.   My new insurance didn’t cover Pill A.  I tried Pill B, which didn’t work, and then Dr. W prescribed Pill C.  I’ve been taking Pill C for almost 2 1/2 years, and it’s been fine.

But now, suddenly, the insurance company won’t pay for it.

So Dr. W gave me some pills to tide me over while we pursue an appeal.

Want to laugh?  One of the alternatives the insurance company suggested is … Pill A.  Yeah, the very same medication they refused to pay for 2 1/2 years ago.

And here’s another bit of irony.  Right now my employer is doing its annual benefits enrollment.  And they told us that, come January, our prescription drug plan will move to a different provider.

I’ll have to go on line later today to see what the new plan does and does not cover.

And that’s what’s wrong with health insurance in America.

Comments

  1. bookwormNovember 1, 2022 at 5:38 PM

    I feel your pain. It won't get better when you go on Medicare, either. Each year we have to re-shop our part D prescription coverage. Either meds went up, meds went off the formulary (each plan has a different one), participating pharmacies changed, or a combination of all of the above. And there's the donut hole, which my husband is in by July. Stay healthy! (I think any American will agree - our system is broken big time.) Alana ramblinwitham.blogspot.com

    ReplyDelete
  2. Liz A.November 1, 2022 at 9:11 PM

    It all went to hell once healthcare providers could make a profit. What a mess.

    ReplyDelete

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