Wednesday, October 12, 2011

Insurance rant

I will try to be brief...
Doctor's office ordered my meds from a specialty pharmacy out of Maine that apparently isn't apart of my insurance's plan.. but they covered my trigger shot from that specialty pharmacy last month.. go figure.  So, today... new drug order was put in to that same pharmacy.. we figured it was a go because they covered it last time.  Specialty pharmacy called and told me that insurance told them that I had met my lifetime max in prescriptions.  This = false.  Me = displeased.  I called my insurance and they told me that they told the pharmacy that because they have their own specialty pharmacy.  This = they lied to the pharmacy and put me in a panic.  I am no where near hitting my lifetime max!  They've only covered 2 medications for this whole process.. I had to pay out of pocket for the others because they weren't covered.  Ridiculous!  So then I had to call the insurance's specialty pharmacy to see if they even offer the injectables I need and they do.. so called doctor's office to give them the news and now I wait. 

Chances are.. the pre-auth on my meds won't go through in time and then we'll have to wait for next cycle.   If this wasn't so time sensitive it wouldn't be that big of a deal.. but I need to start my meds no later than Friday.  Anyone know how to speed up the pre-auth on meds??   

Patience, Crystal... Patience!! :)

1 comment:

Michelle said...

DAH! That is so frustrating! We've actually had really good experiences with specialty pharmacies and usually get Nate's meds within a day or two, so hopefully you have a good fast one like ours. But seriously, insurance companies can be SO LAME!