Wednesday, January 13, 2010
Who Are We Kidding?
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.
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.