Saturday, February 04, 2012
Living in the United States we hear day in and day out and how much of a money maker the health care industry is for the pharmaceutical companies and health care providers. It's a fact of life and becomes more expensive every year. I am thankful that I have coverage my employer offers and for the first time in my professional career I don't have to contribute. Therefore, I am not looking a gift horse in the mouth.
Recently and at this time I am experiencing difficulty in getting a simple prescription filled for a medication I have been on for the last two years. Nothing has changed regarding the availability of a generic so the brand name is the only option I have. What has changed is the health care company wanting to pay for any portion of it. Perhaps my frustration is felt at the level it is because this is the first time I have ever experienced this challenge. Not only is the health care company giving me the run around but they are doing so with the pharmacy and my doctor's office. As I have come to learn, each year a policy renews the health care company and pharmacy determine the formulary and are in no way required to notify the patient of said changes. I think they should be required to do this so there are no "surprises" when someone goes to have it filled, which is the only way of finding out when a change occurs it seems. Credit card companies are required by law to advise when changes occur in their policies so why can't the same be expected of the health care companies?
I don't like an administrator somewhere who just sees bottom line dollars determining what is best for me when they are not my doctor. I am aware this has been going on for years. It is beyond frustrating to have an administrator somewhere who knows nothing about me, my doctor/patient relationship and my medical history to suddenly demand I change to something all for the sake of them saving a buck. I have no idea how I am going to react to something that wasn't prescribed and should there be an adverse reaction to something and I should happen to land in the emergency room the health care company has now just cost themselves more money.
What's even more frustrating is there is nothing I can do about this except get what they will cover or pay for things out of pocket. I know I am not alone in this and there are many who are also experiencing increased difficulty in obtaining medication prescribed by a doctor.
It's been almost a week this has been going on. While they fight back and forth and the insurance company gives my doctor's office a run around I have to go without until something is figured out. Thankfully, I have a good doctor who has a staff that has kept me in the loop through this and are doing all they can.
The level of surprise I have experienced is a result of seeing this simple fact for the first time and how much things have changed through the years and the fact its something totally out of my control.