Just a Minor Rant About Various Insurances

I will make this no secret, and I think it's an opinion that many people in this great nation of ours share: I hate insurance companies. Really, I do. More than the companies themselves, I hate having to attempt to explain them to customers; mostly because I really don't know much more about their particular plan than they do. I know whether or not your insurance company will pay for something (but only after attempting to bill them, keep that in mind), I can tell you how much they were willing to pay (again, only after I've actually billed them), and I can tell you if they denied it, and will accept a prior authorization from your doctor.

That's about it. Other than that, I must point out, it is completely and totally useless to ask me about your plan because I have no idea why you seem to be paying seventy-five dollars one month, then twenty-five the next, then back to seventy-five after that. It's just as much a mystery to me as it is to you, but I digress.

Back to the subject at hand... I hate insurance companies. People pay good money to be "covered" by insurance companies only to discover that they're going to end up paying through the nose anyway. They have ridiculous rules of coverage, and I sometimes find their list of "covered drugs" to be supremely lacking.

Here is a list of medications that I have had to send out PA's for:

• Levothyroxine
• Simvastatin
• Clonazepam
• Liothyronine

That's just to name a few. Note that these are all generics, and except for clonazepam (a C-V), I do believe are covered under my companies generics program. What insurance company askes for a frigging PA for simvastatin? Most insurance companies prefer it because it's one of the cheaper ones! I wish I could remember so I could post their name here and play the shame game, but my mind is drawing a blank.

Another lovely little quirk I've come across was a company that only filled five hundred and fifty fills in a six month period. Meaning that if you're on several essential medications and the combined number of fills for all of them exceeds five hundred and fifty in six months, your insurance company stops paying. Imagine you're on nitrostat for chest pains because you've had, or are at risk of having, a heart attack. Your other medications for blood pressure, blood clotting, and that pain medication came first and took up all your fills, so now your insurance won't pay for potentially life-saving medication because you happen to be on too many medications for their liking. I wish I could blame that one on Medco or CVS Caremark, but alas, I cannot.

Speaking of Medco and Caremark... Allow me to shed some light on why I hate them. I know I'm not alone in this, because everyone who is covered by them that I deal with regularly hates them. I hate how they work, and how they tirelessly seem to enjoy making my life, and by extension the lives of their customers, more difficult than it ever should have to be.

My company doesn't have a ninety day "contract" with Medco. Which means that if we try to fill one of their customers' medications for a three month supply, they go, "Nope! Don't wanna, and you can't make me!" It really is trying on my nerves to have to send the script back to data entry because they don't feel like cooperating with us to get a ninety day contract. They also really like that mail order. So much so that they'll stop paying after a certain point on certain medications because they want the customer to use mail order instead. It's basically a bullying tactic of, "Oh, so you want your medications now? Too fucking bad. Here are some flaming hoops to jump through if you reeeeeeeeeeally want them. Oh, and hold still while I douse you in gasoline first..."

As for Caremark... I just don't care for them. I really don't. They have a lot of the same issues as Medco above, and attempting to call anyone at their "help desk" is infuriating at best, down right rage-inducing at worst. Not to mention that I think I keep missing the pleasant techs because every single one that I've spoken with to date has been incredibly rude and condescending.

And the pharmacists wonder why I put off having to call these Hell spawn. I almost wish for a universal healthcare system so that 1.) Canada and Europe will stop laughing at us and 2.) I never have to speak to those wastes of air and flesh again.

That would please me.