Wednesday, January 13, 2010

Who Are We Kidding?


Since Monday, I have been experiencing the madness surrounding healthcare that is going to become even more prevalent in the future.

On Monday, I ordered prescription refills online and noticed that one of my medications was listed as nonrefillable, which was odd because the bottle clearly stated I had one three-month refill remaining.

I called customer service and that is where the madness began. I was told, as of January 1, 2010, the drug needed prior-authorization. I would need to contact my doctor who in turn had to contact the insurance company and file a pre-authorization request.

Okay, I know this process is understandable for speciality medication, but I don't see how extended-release nitroglycerin capsules would qualify as a speciality drug.

I had checked the formulary I received in November to make sure all of my medications were listed and they were. There on the list plain as day was "Nitroglycerin"; however, my error was not digging deeper and seeing if my particular type of nitroglycerin was listed in the unabridged formulary. After my conversation with the representative on Monday, I checked the online formulary. It has a lot of nitroglycerin products listed, but my particular one was not there.


Plan B - I called my cardiologist's office and spoke to a nurse. She was surprised about the need for pre-authorization for the extended-release nitroglycerin. She said she would take care of it.

Fast forward to this morning. I received a pre-recorded call informing me that the pre-authorization had been denied. The nurse was surprised when I called to inform her and said that she would contact the doctor to try and find a substitute medication for me.

I have been taking this drug for four years with great results, and now I am being forced to use a substitute that may or may not be as effective.

Healthcare reform has become a popular buzz phrase, but we are fools to believe healthcare reform will be the remedy: it all comes down to dollars and cents, not in our pockets but in the pockets of the insurance companies.

Fasten your seat belts folks, this is going to be a bumpy ride.

6 comments:

  1. I agree. I had a similar issue with one of my grandmother's meds and the insurance company. Ridiculous!

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  2. I was going to comment, but get too angry on the subject!

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  3. I call it prescription wars..as soon as we get used to something they change it. It is very frustrating. I hope it gets better..but I doubt it.
    To answer your Question about how I label the photos.. I use creative names..and lots of different files. You can also write the name, location and date on a small slip of paper and scan it right along with the photo if you don't want to name each scan.

    I love your handkerchiefs and linens.. I collect them too:)

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  4. One of my persriptions has gone up a large amount for no good reason that I know of and you know that once something goes up it rarely goes down.

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  5. I hope you get it all straighten out and that the new medicine works just as well as what you have been taking.

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