at a loss for words part 2

Published April 19, 2013 by emotionless brain

Well after a second appeal to the insurance company they agreed to allow my medication as my prescribing MD has prescribed it instead of how they think it should be taken. This fiasco has had a very negative impact on me, it has created un-necessary stress, cost me financially (I will explain), my work productivity has not been up to par, etc, etc.

The financial expense has been that I had just filled a 90 day supply of one of my meds (at an ungodly price), then had to get new prescriptions at different dosages. Apparently 90 day mail order is no longer lucrative, you pay the same price as a 30 day supply at the local pharmacy. These meds are tier 3, and do not have generic, my opinion of the tiers set forth by the insurance companies is a racket. Especially when one can prove failure on “generics” or Tier One. Another way for the insurance companies to gouge the innocent consumer. I also have the mind set that the working class people bear the financial cost of the free loaders. (another subject for another day).

I do not like change, when I get into a routine, and I find a a pattern that works effectively I do not like having my boat rocked. That is not saying I do not enjoy an occasional impulsive activity (I am taking the kids for donuts this am (a very very rare treat). It took months of trials and tribulations to find dosages that work of my two medications for my ADHD, why is it OK for the insurance company to rock my world and try to label me “non-compliant”.

 

Life is good, by next week I will be back on my correct dose of ADHD meds, and will also have started a new med. Had blood work done a couple of days ago, apparently age has caught up with my hormones (and the surgical removal of my parts too). I have been miserable hot, cold, glistening with drops of pearly dew (ladies do not sweat) day and night. I refuse to consider the debate of hormones vs not, I have enough other issues in my life right now. Donuts here we come…

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3 comments on “at a loss for words part 2

  • My 23-year-old daughter is having the same insurance company issues. I’ll never understand how a minimum-wage clerk can second guess a physician and get away with it! Doctors and patients work long and hard to find effective dosages and combinations, and it’s appalling that you could be labeled “noncompliant.” Enjoy that donut! Not sure it will help with the pearly dew, but if it does, order a dozen for me, okay? 😉

    • Because of my over 20 years in the medical field I understand both schools of thought, that does not mean I will be acquiescent to their shenanigans. Fortunately my prescribing MD is all to familiar with insurance company shenanigans and knew exactly what to say in a letter back to the insurance company. I too will be writing the insurance company and the state board of Insured. The donut was good for the soul but did not not help the hormones. I will be much more comfortable when I can get some HRT. Let your daughter know she has a voice and can fight the insurance company (unless it is Medicaid), do not “just accept” what they say. One thing the insurance companies count on is most individuals not knowing their rights, or taking the time and energy to fight for them.

  • An attention-grabbing dialogue is worth comment. I feel that you must write more on this topic, it might not be a taboo subject but generally persons are not enough to talk on such topics. To the next. Cheers

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