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THOSE DARN INSURANCE COMPANIES
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An_250887 posted:
Dear anyone willing to hear my RANT! This is not the first time this has happened to me and of course this will not be the last.

How did the insurance companies ever become so almighty in this country and why did the citizens allow it to happen to us.

Last week, one of my medications was changed at the PM clinic. I am on a few medications and the one discontinued med is a high enough dose to cause serious withdrawl symptoms. I have gone through this at a lower dose, complete with the N/V and the lovely feeling of "worms crawling" under my skin.

So, they deny and close up shop for the weekend. I get on the phone first thing Monday and make all the calls. Physician, pharmacy and attorney--so tired of this game after 25 years.

Insurance company requests and receives the documentation they have requested and tell me to wait for 48 hours. I call this a.m. to the same three rounds of calls, only to find out, the insurance company wants a "form" filled out. Of course, this "FORM" was never mentioned on Monday morning. Now, they say it is customary for them to take 24-48 hours to "review" and make a decision.

Why is it, if I am switched to a cheaper medication, none of this takes place due to a switch in meds? Last time the med change was never approved and I had to drive to the other side of the next town, when I felt horrible and get a cheaper script.

This is all (you know what). I hate to sound ugly, but on days like this, I do not feel very charitable concerning this type of policy/behavior. Those of us are going through this now, but in the future, these insurance employees will age, get sick, become injured and vulnerable in a system where they once participated each day.


Here is to hoping, in the future, they all have surgery or get sick on July 1st.

No hate mail please.
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trs1960 responded:
Absolutely agree.
This is why I argue against any increase in regulations or oversight over MDs by non MDs such as legislators or insurance companies. The insurance companies will say it's in your best interest to only allow you to have a few pills of drug x at a time. While a good pateint and pain doctor know that you should have enough on hand to handle in precription issues, natural disastor creating shortage or a breakthrough pain in which you need releif that can not be given in the time it takes to be seen by your doctor and have a prescription filled.
Most insurance companies see any prescription that is for an existing medication you are taking and with out a dosing change as a refil no matter what the doctor's intent is. I once had ab reakthrough pain issue and had to take some an increase in my dosing to get through a very bad week. I discussed this with my doctor and told him exactly what I was doing over the phone with full disclosure. He made an appointment to see me as soon as his schedule permitted. he wrote me an extra prescription to make up for the medication I had consumed to prevent exactly what you describe above. The insurance company wouldn't pay for the medication as I already had a refill on file. I discussed (argued) with the insurance rep and asked where he had recieved his medical training? He had none...hmm.

I say this knowing that there are people that need to be kept away from narcotics and can be put at risk, but that's why such drugs require a doctor's signature with DEA number. It is already all, but impossible for general practitioners to prescribe long term narcotics or to disable a patient they have known for 20 years.

Best of luck,

Tim
 
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jselleck replied to trs1960's response:
my gp won't even prescribe pain medicine anymore. She just refers me to my back doctor or asks if I can wait a day or two for the pain to decrease. Do you have any idea how bad that is over a week-end??? Horrible!!! I've had it so many times with our insurance company over so many different things that if my husband's job wasn't the highest paying he's landed in his "field" and his employer didn't take such good care of their employees I'd tell him to quit and find something closer to either his sister or my family. That's how much I had our insurance. And my bipolar friends know even more about my "run ins" with my company. I think everyone who works there should have some type of medical training as a prerequisite for their jobs. The only understanding insurance workers I've ever run into are my cousins, and I don't know if they were just nice to me because we're family, or what.

Anyway, that's my rant. Have a good day and hope I didn't offend anyone.

JSelleck


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