Tuesday, August 11, 2009

More Insurance Company Fun

The insurance company has been sufficiently reassured that, yes, I would be taking an anti-anxiety/anti-depression medication to combat anxiety and depression! Bonus - as a result of my doctor's sound judgement with her drug therapy, it was found to adhere to the plan's guideline for coverage. I was able to pick it up for a whopping $23.79. Whew! Being cranky is exhausting!

It’s no big secret that my life can be crazy. I have a child with special needs, a stressful job, another child who thinks she is Demi Lavato, a furry hyperactive child who has recently decided to dig to China via my backyard, a house falling down around me, a 1 ½ hour commute each way for work and a traveling husband. And that’s all stuff I’ve already admitted to. :-)

So, I have bouts of depression and major anxiety issues. Major. Like, I can’t really seem to sleep and think the sky is falling anxiety issues. I have taken medication for this stuff for a couple of years. Recently, though, my favored medication stopped working. This is common with anti-depressants and my doctor decided we needed to try something in a different drug family.

Imagine my lack of surprise when I went to pick up this medication and found it was denied by my insurance company. When I called to find out exactly why it was denied, I was told I needed prior authorization. That made me a little, well….crazy.

This is the response I received from the “Prescription Insurance Company Practicing Medicine on the Side” when I told them their logic was moronic at best, but mostly just plain old irresponsible. I have changed the identifying information only because I recognize that the people who work for this evil organization know not what they do.

And what they do is…make me crazy.


To Crazy Mama,

Thank you for your online inquiry. According to plan design, Wellbutrin tabs require a prior authorization before it is covered. To initiate this process, please have your physician call 1-800-***-****. You can verify with Member Services that the prior authorization has been filed with Prescription Insurance Company Practicing Medicine on the Side. Once the prior authorization has been filed, a prescription may be submitted for processing.

Prior authorization occurs to ensure that prescriptions are being used for the purposes covered under the plan. When your prescription is filled, it is electronically submitted and instantly reviewed for eligibility, coverage, health, safety and cost issues.

This is to ensure that the drug being prescribed will not interact with any other medications you're taking or any allergies you have. In some cases, certain drugs have other uses that are not covered or are not considered effective. When this occurs, coverage for the prescription is denied.

In all cases, it is your physician who determines which drug therapy is prescribed for you. On occasion, your physician may need to provide additional information to determine if and how much of a drug will be covered by the plan.

If your use of the drug doesn't adhere to the plan's guidelines for coverage, you will be responsible for paying for the full cost of the drug.

Thank you for visiting justtrytogetmedication.com.

Catherine D.
eCSR for Prescription Insurance Company Practicing Medicine on the Side

If you have any further questions or issues, please visit our site at http://www. justtrytogetmedication.com

This e-mail message and any attachments contain confidential information from Prescription Insurance Company Practicing Medicine on the Side. If you are not the intended recipient, you are hereby notified that disclosure, printing, copying, distribution, or the taking of any action in reliance on the contents of this electronic information is strictly prohibited. If you have received this e-mail message in error, please immediately notify the sender by reply message and then delete the electronic message and any attachments.

1 comment:

  1. Sorry...Im laughing at your "justtryandgetmedicine.com"...your right, that make me nuts too... I hate insurance companies.