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insurance argh
May. 16th, 2014 12:15 pmSo, I have a new doctor, which is a good thing. But Monday, when I went to pick up my blood pressure pills, the pharmacist asked, "Did anyone talk to you about preauthorization?"
No. Why would anyone talk to me about preauthorization.
The insurance company doesn't want to pay for the dosage I'm taking, which is 60 pills. They only want to pay for a normal dosage, which is 30 pills, unless I have a preauthorization. The fact that the doctor wrote the prescription isn't enough; he also has to give the insurance company a preauthorization. The fact that this is the same dosage I have been taking for years, that the insurance company -- the same insurance I have had for years -- has been paying for for years is irrelevant. It was no-one's responsibility to warn me about this before I ran out of pills. The fact that it will cost the insurance company more in the long run if I have a stroke? Well, maybe I will be on some other insurance company's books by then.
Probably, 60 pills of the high dosage ACE-inhibitor and diuretic combo is not the best way to manage my high blood pressure. My old doctor started with the diuretic, added the ACE inhibitor, and then kept upping the dosage until it worked. She never tried beta-blockers, which, according to my reading, are more likely to be effective on high blood pressure in someone who has as much anxiety as I do. But, as my old doctor liked to remind me, I do not have an M.D. But neither does the nickel-and-dimer in the insurance company!
So, Monday, I called the doctor's office and explained the problem to the person who answered the phone, who said she would leave a message for the medical assistant, who would arrange the preauthorization and call me back when that was done. What should I do in the meantime? I had accepted from the pharmacist the 30 pills that was all my insurance company would pay for. Should I take a half-dose this month, because the preauthorization can't move back in time to preauthorize the 60 pills I need this month? Is there any way around this? (My trip to Wiscon is not going to be low-stress.) I did not think the person who answered the phone would know. I thought I could ask the medical assistant, who deals with insurance companies, when she called me back. Unfortunately, she didn't call me back. I have called the doctor's office again. This time the person who answered the phone transferred me to the medical assistant's answering machine, so I left her a message myself. So I am waiting again. But what should I do in the meantime?
No. Why would anyone talk to me about preauthorization.
The insurance company doesn't want to pay for the dosage I'm taking, which is 60 pills. They only want to pay for a normal dosage, which is 30 pills, unless I have a preauthorization. The fact that the doctor wrote the prescription isn't enough; he also has to give the insurance company a preauthorization. The fact that this is the same dosage I have been taking for years, that the insurance company -- the same insurance I have had for years -- has been paying for for years is irrelevant. It was no-one's responsibility to warn me about this before I ran out of pills. The fact that it will cost the insurance company more in the long run if I have a stroke? Well, maybe I will be on some other insurance company's books by then.
Probably, 60 pills of the high dosage ACE-inhibitor and diuretic combo is not the best way to manage my high blood pressure. My old doctor started with the diuretic, added the ACE inhibitor, and then kept upping the dosage until it worked. She never tried beta-blockers, which, according to my reading, are more likely to be effective on high blood pressure in someone who has as much anxiety as I do. But, as my old doctor liked to remind me, I do not have an M.D. But neither does the nickel-and-dimer in the insurance company!
So, Monday, I called the doctor's office and explained the problem to the person who answered the phone, who said she would leave a message for the medical assistant, who would arrange the preauthorization and call me back when that was done. What should I do in the meantime? I had accepted from the pharmacist the 30 pills that was all my insurance company would pay for. Should I take a half-dose this month, because the preauthorization can't move back in time to preauthorize the 60 pills I need this month? Is there any way around this? (My trip to Wiscon is not going to be low-stress.) I did not think the person who answered the phone would know. I thought I could ask the medical assistant, who deals with insurance companies, when she called me back. Unfortunately, she didn't call me back. I have called the doctor's office again. This time the person who answered the phone transferred me to the medical assistant's answering machine, so I left her a message myself. So I am waiting again. But what should I do in the meantime?