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General Category => The Coffee Shop => Topic started by: IBMer on February 08, 2013, 09:34:00 pm
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So I went to CVS today to get my Life Sustaining Insulin. They told me that I had plenty of refills, but that the insurance company refused to pay. I asked what was up.. The insurance company wants your doctor to call them to validate. What does that mean, I have 20 refills, and I obviously need these meds. The Pharmacist tells me, it's not us, it's between your doctor and the insurance company.
Ok, but I ran out of insulin yesterday and you are telling me that I have to go without until Monday or Tuesday because the insurance company wants the doctor to validate. He added that the insurance company wants to switch me from Humalog to Novolog. Good for them, and in the mean time I'm supposed to go into Diabetic shock. That's great, so the insurance company rather pay $30,000 when I have to go to the Hospital and spend the weekend there than pay for my meds now... Perfect. He told me, but we can give you your other meds.. I told the man, without insulin, what's the point... Much good will the cholesterol medication do me when my kidneys fail.
Apparently stupid looks and blank stares are still Absolutely FREE.... That's just incredible that an insurance company would deny a patient of life saving meds, when they have refills on file, because they want you to use a cheaper medication. If the doctor wanted me on different meds, he wouldn't have me on Humalog.. Oh, and for something like 8 years...
I told my GF that if I end up in the hospital over this, that it's her job to sue them all.. Thank you CVS, and Blue Cross Blue Shield, your customer service and personal touch are just amazing!
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Yea I know they like do stuff like this its a crock of yaahoo if you ask me.
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Didn't think much about insurance til I got the big 'C", now I look at those bills that for the most part they are paying and have a new understanding...though @over $1800 a month in premiums I really feel like I'm paying my share.
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I can see them wanting to change an antacid, or allergy meds, but you don't cut someone off from Insulin. Diabetics go into shock and die without insulin. I told them that I ran out 24 hours ago. They didn't care.
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I'd sue the a**e off them for putting your life in danger (diabetes is a killer if not controlled with meds) and also for all the stress they're putting you through. If they want to change the meds that a doctor prescribes then they should discuss it with the doctor while continuing to supply the prescribed meds, not stop your meds and put your life at risk.
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That is absolutely disgusting. I really hope you stay well until Monday when you can sort it out. Please take care.
Marg
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It is disgusting! Can't you just buy enough to get through the weekend and sort it out? I would really be upset with them though and I would try to get to someone who has some authority on the matter. It is just wrong. :(
Sheila
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It is discusting, and it's the reason I loath insurance companies. I had the same thing happen to me with other maintenance medications, and the kicker is that I had been on them for years when they changed their "prefered medications" list. What really chaps me a** is that they don't call you or your doctor...you find out when you go to pick them up. and the really bad thing is that our costs keep going up to boot!! God bless corporate greed.
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And now you understand just why I intend to get everything fixed that I can before midnight, Dec. 31, 2013!
Obamacare kicks in full force in 2014 and it will get progressively worse!
~~~GB~~~
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Obama Care already hit home for me...they cut my wife back to 24 hours a week just so she won't be eligable for insurance where she works. I carry her on my ins. but it still put a big dent in our wallets.
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Obama Care already hit home for me...they cut my wife back to 24 hours a week just so she won't be eligable for insurance where she works. I carry her on my ins. but it still put a big dent in our wallets.
Alot of places are doing that, cutting back hours on people to keep from paying insurance or having to offer it. Or even laying off people to keep from it. Its more or less screwed those that are hard workers and are trying to make a living.
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A couple friends suggested that I buy my meds outright then work with the insurance company. But since I don't have $1400 handy, I guess I'll wait until Monday and take it up with my doctor.
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I just suggested you buy for the two day weekend to keep you out of the hospital. Then take it up with your doc. I wish you all the best.
Sheila
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One of the major factors that influences a diabetics sugar levels is STRESS. None of us need it least of all a diabetic. You are on Humalog for a reason, and that was because it works for you. I certainly hope I don't see the day when the insurance company screws with my wife's insulin.
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Sorry I haven't been on in a few days. Sometimes insurances will OK a 3 days supply to get through the week end but evidently not that one. There should have been a Doctor on Call for your doctor that might have been able to approve for short time anyway. Dealing with insurances is not always fun. I deal with Medicaid mostly so have a taste of our new Affordable Care Act. Pretty much is the folks you deal with are not necessarily educated in medical care and most likely High school grads. The computers have a lot of data and if the criteria does not meet the set rules it kicks it out but no one knows how to check with common sense. I know it is late to answer but maybe this will help another time. Just remember the original medical law was a little over 2,000 pages and that has grown to over 13,000 pages in regulations and it is not even close to fully unwrapped It will be interesting next year.
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I am diabetic to and have had the same thing happen. With insulin you usually buy it a vial or more at a time. It isn't possible to buy 2 or 3 days worth in many cases, and if you have to pay for it without the discount the insurance companies get, it is expensive. I actually spoke with an insurance representative once when in this same situation and told her if I die this weekend while you are straightening out this problem, expect a huge lawsuit that will make a vial of insulin seem like a dollar. Didn't change her opinion a bit.
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The Nurse called me this morning. It seems that the Insurance company Won... The insurance company now tell doctors what they can and cannot prescribe. I bet this will put thousands of Medical Sales Reps out of work. After all, why bother pushing one medication over another to the doctor office, then the Insurance company has all the power to decide what they will and will not pay for.. Seems like a great opportunity for a monopoly to me. Insurance company buys stock in company A under a shell company, forces doctors to use meds from company A and basically monopolizes the market.
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IBMer, they already basically have a monopoly. One of the reasons insurance is so high is because competition is limited because the law prohibits companies from purchasing insurance outside of their own State. A few years ago I dated a gal who had to buy her own health insurance because the Company she worked for was in Michigan and had no branch in Ohio, so in essence it was illegal for them to offer her insurance...makes a lot of sense doesn't it?