I had to retire unexpectedly last year for health reasons. Hubby and I are both 65 years old. We have been using Blue Cross Blue Shield insurance for over 10 years with no problems. At the end of last year, hubby’s company informed their employees they were switching to UnitedHealthCare. We were told it was an easy transition, the insurances appeared to be almost identical. It was even approved by AARP. Ok, no problem.
Now it is January and the switch has been made. We are beginning to run out of monthly prescriptions and calling in reorders. First, last week, hubby’s diabetic medicine was declined. We were informed it needed to be pre-authorized because they didn’t approve of this drug, it costs too much. Well, when he is out of his prescription and standing at the pharmacy to pick up the refill is a heck of a time to tell him this.
And so, calls to the doctor, to the insurance for pre-authorization, to the pharmacy and back and forth. End result, he got some samples from the doctor to tide him over till next month’s office visit. The insurance will not authorize this drug and he needs to make a change. Do you know how scary it is to ‘rock the boat’ with the drugs you have taken for years and learn you need to pick something else?
Okay, now today, he is standing at the pharmacy counter once again, to pick up two refills of anti-seizure medication. He is out of both. He is informed that the insurance put him in an automatic mail order program and he has to call to opt out of that program to be able to pick them up as usual. Of course, that means he calls me ranting in frustration for me to call and ‘fix’ this.
I start freaking out. At our age, dependent on our monthly prescriptions and our normal routines, unexpected changes are scary! I fall apart talking to the company that I call to opt out of the program. I am told it is to help save money in the long run, yada yada yada, and I can keep the mail order option or not and either way, they can authorize the drug for immediate pick up since hubby is out. I opt out for now and thank the man and hang up so I can freak out some more in private.
I calm down and call the pharmacy. I tell them they can put his prescriptions through again, that they have been authorized. They check while I am on the phone and tell me the most important drug he needs today is not one the insurance will pay for. If we want it, it costs $265. I fall apart on the phone again, not knowing what to do.
The woman on the phone was so kind and helpful. She put me on hold to talk to the pharmacist. She came back and told me there was another brand of the same drug and they would do a switch. The alternate brand was accepted by the insurance but his was not. I asked was this like a generic drug so I could understand what she was telling me. She said yes, same drug, different brand and the insurance would pay for it. And no need to go back to the doctor to try to figure out a different drug to take instead. I am so relieved and so appreciative to the woman on the phone and the pharmacist!
OMG. Do you know how scary this was for me? You take certain monthly drugs for years and all of a sudden something changes and you worry about your health. You have something that works and you don’t want to have to mess with what your body is accustomed to! My husband is ranting about the insurance company. I’m saying it isn’t their fault, they are doing business as usual. We just happen to be used to our other insurance and have to get used to this one. OMG. Between the two of us, we probably have around 12 monthly prescriptions we depend on. The price of aging, I suppose. But you would think the insurance would check our records and realize we have been taking the same thing for a long time and we don’t need to mess with our health as well as our emotional well-being with surprises like this!
Ok…rant over for now. I feel better, sort of. Talk about stress. Now you get to see another side of me. The side that can freak out at unexpected changes. All done now. See you next time. The journey just got more interesting…