Monday, September 10, 2012

Insurance hoops

In January of this year, my employer changed health insurance companies.  For the better part of the last ten years, I've had Humana as my carrier.  They have always been fair and helpful.  On the days when I did end up having to call customer service, it was usually quick and painless.  Not anymore!

We now have Blue Cross/Blue Shield of Florida....and can I just say....I really, really dislike them.  According to the human resources department, the change from one insurance carrier to another was supposed to be "seamless" to us.  We were not supposed to see "any difference".  HA!

Besides having to change information at every doctor's office and on every school or medical form, I've also had to pay a much higher premium!  I'm paying around $800 per month for coverage for our family!  This does not include the higher co pays....$25 for the regular doctor and $45 for specialists....and $75 to $100 for scans or outpatient procedures.  I've also had to change one doctor (who is not on the BC/BS plan) and deal with the fact that several of my routine (but cancer related) medicines are now on a higher tier.   It all boils down to more money from us!

Now, I realize that health insurance is a luxury and a privilege.  It's not a right!  I get that.  Trust me, I'm extremely thankful that my company offers coverage at all!  Many of my friends and family do not have this as a benefit.  But, I do work for a hospital and it does seem like the right thing to offer services to the very employees that make the services that others receive possible.

For a family that is healthy, none of this would seem like a big deal.  BUT, if any member of your family has a serious illness, the stakes are higher.  Literally.

Just today, I went to the pharmacy to get a new prescription filled.  My oncologist has changed my medication from Arimidex to Femara.  When I walked in there to drop it off, the whole place was a wreck.  Apparently, the roof leaked over the weekend and they are having to replace furniture, carpet and merchandise.  As a matter of fact, when I was there last week, they had just placed a brand new ATM machine in there.  It was gone today!  Probably ruined by water damage.  Bummer.

When I talked with the pharmacist, she explained that they do carry that particular med there, however, she only had 18 pills on hand.  She was going to fill my script with those 18 and then I would have to come back later to get the rest filled. Lovely.  This almost always happens to me!  It never goes smoothly when I get my prescriptions filled.  Sigh.  I said "OK" and went outside to wait (no place to sit in there today).

About 10 minutes later, the tech came out and said that, get this, they can't fill the prescription because the Femara needed to be pre-authorized.  Are you kidding me?  She said she would contact the MD's office and then they would need to contact BC/BS. 

I called my oncologist when I got back to the office.  They said they couldn't do anything until the pharmacy calls them.  I'm hoping that they are all communicating the way they are supposed to.  I've only got about a weeks worth of the Arimidex left.  They don't have much time to get this straightened out!

All I know is that....I'm tired of jumping through the insurance hoops!  I mean, I don't even like basketball!

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