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Topic: Insurance Company *&*^%$$# (Read 325 times) |
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BarbaraD
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Insurance Company *&*^%$$#
« on: Jul 18th, 2007, 11:27am » |
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I'm ready to go postal ---
Ok, I finally got a med policy about a year ago -- it's got drug coverage with a co-pay -- ok I can handle that one...
Now, a couple of months I go to the doc and he tells me I'm gettin' old and have arthritis (who didn't know that?) and need to take Celebrex (ok, I can do this - took it some years back and it worked fine). So I run off the drug store to pick up my script.... Trouble starts -- it has to be PRE-APPROVED! (Why?)
I calls the insurance company and asks WHY? They tell me it's so they can check to see if it's a pre-existing condition -- Hell I'm 63 - it's for arthritis -- DUH! I tell the nice drug store to fill the damn thing and pay for it!
Next month -- same thing -- (how long does it take to check this out?)
Now here it is third month and they still don't have it checked out. The woman at the damn insurance company had the nerve to ask me if I'd tried anything else -- THE DOCTOR ORDERED CELEBREX and it works!!! What else do you need to know???? She said they'd call the pharmacy and see if they could find an alternate med for me. Now I'm about ready to come unglued. I just called the pharmacy and they haven't called them and I told them to fill the damn celebrex and tell the insurance company to go to hell.
What is wrong with a doctor practicing medicine these days. The doc SEES the patient and should know what the hell the patient NEEDS, yet the insurance company can TELL you what med THEY want to you to take????
Right now I'm about to bust a gut. I'm not sure what I'm going to do but I'm madder than a wet hen.
Hugs BD
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Rosybabe
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Re: Insurance Company *&*^%$$#
« Reply #1 on: Jul 18th, 2007, 11:34am » |
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Hi Barb!
yeah Insurance companies are the ones who decide what meds we can take and how many days we can stay at the hospital..no the Doctors.
just in case I wanted to be sure you know some facts about Celebrex, please chek this site:
http://www.fda.gov/cder/drug/infopage/celebrex/celebrex-ptsk.htm
Take care!
Rosy.
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Charlie
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Re: Insurance Company *&*^%$$#
« Reply #2 on: Jul 18th, 2007, 6:38pm » |
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Insurance companies....thanks to the lessening of oversight; are evil. Capitalism gone wild. It's great so long as old and infirm people don't die from it. Arthritis begins as early as your teens and certainly in your 20s. Nobody doesn't have some form of it. Bashtards. Try getting some samples from your sawbones. I got a passel of anti-convulsants from my Neurologist while waiting for insurance to take hold.
My state-assisted (not Medicaid) insurance calls Differin cream, a cosmetic and not covered. 
In order to afford it, I got a prescription through Canada for about a third as much as here. Naturally, new FDA guidelines have made importing drugs from Canada something on a par with getting Plutonium across the border so the drug company CEOs can have golf courses in their back yards.
I sent copies of prescriptions and ID to British Columbia. This stuff is manufactured in Canada, by the way,  ...... but because of our limp-wristed politicians, it has to be sent from Calcutta and it took nearly four weeks to get the stuff....it was ripped open by customs of course. One positive thing is that because of this insane system, I discovered that I no longer need the stuff...makes me wonder about my other drugs...
Have you tried fire-bombing yet?
Charlie
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| « Last Edit: Jul 18th, 2007, 8:19pm by Charlie » |
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Jonny
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Re: Insurance Company *&*^%$$#
« Reply #3 on: Jul 18th, 2007, 7:49pm » |
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Not so long ago (back in the day) doctors got paid to care of you. Now, HMO,s and the like pay doctors less if they order to many expensive meds or tests.
Just for the sake of profit!
I went to a specialist for my sciatica and he told me it would take some kind of electrical current test to find out what nerves in my leg were fucked up, due to the discs in my back......I said great lets do it!
He said, no, lets try physical therapy.....hmmmmm, I wonder which costs more....having full tattoo sleeves probably didnt go over well that day with this ass-hole.
To this day every step I take is with some degree of pain, why do I do it?.......because I work 10-11 hours a day and have no time for physical fucking therapy.
Fucking scumbags! 
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| « Last Edit: Jul 18th, 2007, 7:49pm by Jonny » |
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PollyPocket
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Re: Insurance Company *&*^%$$#
« Reply #4 on: Jul 18th, 2007, 8:43pm » |
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Gotta respond to this one:
Barb, doctors and patients are no longer in charge of our (and our own) healthcare. The fuckin insurance companies are COMPLETELY in control and even if our docs prescribe, its "f/u we'll decide what this patient needs".
I'm with ya on this one 200%. My co-workers pay 1/2 of what I do in premiums, but because I have a "pre-existing" condition I pay 2x the amount, and ya know what? They won't cover me for said pre-existing condition! So I pay TWICE THE AMOUNT FOR NON-COVERAGE.
I've got cycle coming up soon, and the doc says to me when I asked for O2, AND I QUOTE, "no, its too expensive" WTF??????????? Its ok for me to pay out the ass for non-covered prescriptions ok'd by the ins. cos. and pharmaceuticals, but NOT ok for me to pay less out of pocket for fuckin AIR!
Rave on Barb! Its necessary and required.
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artonio7
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Re: Insurance Company *&*^%$$#
« Reply #5 on: Jul 18th, 2007, 9:52pm » |
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As many will attest to... the use of medical grade oxygen is a first line of defense in aborting cluster headaches. My insurance company will still not cover it for cluster headaches and the doctors do not want to be bothered with the red tape.
So I posed a question to the democratic candidates on CNN'S ask the candidates. I wanted to know when the doctors will be enabled to treat a patient according to the need of the patient as opposed to the dictates of the insurance company.
I mentioned that I am a chronic cluster headache sufferer and in one version of the video question I also included a snippet of me getting hit.
If enough people vote for this question following the link below... the candidates will be forced to answer and there is also a chance of it being asked during the democratic convention in South Carolina. The exposure for cluster headaches will be great.
If you would please... go to this site and look for the video titled cluster headache sufferer questions candidates and press on the green "ANSWER" button... it will be much appreciated. http://tinyurl.com/2hv6gz
with warm regards,
Tony
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| « Last Edit: Jul 18th, 2007, 10:00pm by artonio7 » |
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Rosybabe
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Re: Insurance Company *&*^%$$#
« Reply #6 on: Jul 19th, 2007, 1:19pm » |
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Hey Tony I voted twice  ...I will have to vote tomorrow and the day after.... 
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nani
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Re: Insurance Company *&*^%$$#
« Reply #7 on: Jul 19th, 2007, 1:38pm » |
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Sucks, don't it?
When I had brain surgery (for a burst aneurysm) in '99, my docs told my hubby to get my scrips filled before he picked me up from the hospital. There was a holdup on one of them because of the ins company. Late the next day, I still didn't have my meds and the doc told me that the symptoms I was having (visual disturbances, and what I thought felt like brain "spasms" ) was because I wasn't taking it yet. I called the ins co and the pissy lady I spoke to told me it would still be a while because it was on the "preapproved" only list. I then asked her for the correct spelling of her full name so my family could add her to the wrongful death lawsuit. The pharmacy called 20 minutes later saying it was ready. 
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| « Last Edit: Jul 19th, 2007, 1:39pm by nani » |
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Kevin_M
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Re: Insurance Company *&*^%$$#
« Reply #8 on: Jul 19th, 2007, 7:13pm » |
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My present insurance changed noticeably in the last year when it came to name brand meds (Celebrex may be probably one, too). Without a generic, it's like they have no obligation to allow it anymore without paying a whole lot. They search relentlessly for a substitute. My urologist didn't like it but prescribed an alternative generic, he would prefer the benefits of the newer brand med for some reason and was bit sticky about having to change. I had to refer to the huge cost difference before he changed the script.
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| « Last Edit: Jul 19th, 2007, 7:16pm by Kevin_M » |
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SteveFL
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Re: Insurance Company *&*^%$$#
« Reply #9 on: Jul 19th, 2007, 7:50pm » |
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I use Maxalt as an abortive and since they only come in packages of 9 at a time, I wanted to re-fill a prescription in anticipation of some travel (for business), to make sure I had enough on hand "just in case". The insurance co would not pay for a refill until a week later, saying something to the effect that it was too close to the last time my 'script was filled. I asked my Dr about that and he re-wrote a prescription for me, prescribing up to 4 refils per month if needed. The pharmacist told me that probably won't matter, the insurance co can still refuse to pay. based on what THEY feel is an adequate suppy.
Boy, if I could just wish a Kip10 CH on some of those Insurance Co execs that make those kind of decisions! Then they'd be handing the stuff out for free.
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Charlie
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Re: Insurance Company *&*^%$$#
« Reply #10 on: Jul 19th, 2007, 8:54pm » |
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I miss the days of my youth when a pharmacist would fill or give a little refill no matter what. It was before computers. Today, if it doesn't track with some ridiculous guidelines that benefit everyone but the patient, it doesn't get done and nobody cares. 
This afternoon, I walked down in the rain to refill two prescriptions that I use all the time. It turns out that one of them can't be refilled until Saturday. My telling them and I would keep my mouth shut if they would went over like a lead balloon. I really don't think they knew that I was kidding because I know how helpless and ridiculous they are. It would embarrass the hell out of me if I had to look so silly to customers.
Alas; I hate the 21st century so far. 
Charlie
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Patrick_A
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Re: Insurance Company *&*^%$$#
« Reply #11 on: Jul 19th, 2007, 9:03pm » |
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Yes, It sux that an ACCOUNTANT makes medical decisions for us. I have also been a victim of this.
I called the Ins company and talked to 4 different people until the last one finally told me it was an accounting decision and nothing else could be done.
PA
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stevegeebe
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Re: Insurance Company *&*^%$$#
« Reply #12 on: Jul 19th, 2007, 9:16pm » |
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Since the advent of what I like to call, "the in-between people", Health Care costs have become criminal.
Another group/layer of management has entered the process supposedly to save the costs to the patient. Instead what was created is a burdensome, bloated bureaucracy and has become a monolithic cottage industry.
Bottom line...they are the gate keepers of the money.
The petty looters made the headlines...and the real, big-time looters, (insurance companies), are getting away with massive looting.
Tea overboard.
Steve G
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andrewjb
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Re: Insurance Company *&*^%$$#
« Reply #13 on: Jul 19th, 2007, 10:52pm » |
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*&*^%$$#, . i did tony, though it grates me, that i have to play the "politicians" game. i work hard to understand, and fit in to my society. here in the uk, i seem to be paying more and more for the " highly talented managerment team ". andrew.
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