Friday, June 18, 2010

Please Reform MY Insurance!

Gotta love those insurance companies. (Although my doctor's office shares some of the blame for this story.) DH and I work for the same employer, and I've been covered under his plan for a number of years. With the astronomical increase in premiums for 2010, I figured out last fall that it would be much cheaper to cover me separately, since I'm in a lower salary band than DH. Same insurance company, same plan, just a change of policyholder name--shouldn't be a problem, right?

The trouble started in February when I tried to refill my allergy prescription. The drugstore told me that the insurance company refused to pay for it without a "prior authorization," so I called my doctor's office and was told it would take several weeks to process. I called again the following month, to find that they had no record of ever having spoken with me. This time I went in in person, handed them the form, and the office staff was very apologetic, and assured me it would be fastracked. I waited another month, called them back, and was informed that the insurance company hadn't responded yet. I called back again yesterday, and they had no record whatsoever of anything being submitted! This time, I got someone who passed it up to my doctor right away, instead of to her assistant.

The fun doesn't end there. I got a new prescription the same day for another brand of allergy meds. Got a call from the drugstore saying that my insurance wouldn't cover that one, either. Back to the doctor, who went with a generic from the approved formulary this time. Drugstore called again tonight: yes, the insurance company will pay for this brand. Unfortunately, there's a shortage of it (maybe since the insurance company is forcing everyone to use it), and they haven't had any in stock for the last three weeks!

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