Thursday, February 1, 2007

Insure me that I won't go insane....

What is with Insurance Companies??? For the last year I have been taking Ovcon 35 - the pill. I have been taking it to regulate my periods - which had become WAY too heavy and were seriously getting in the way of living my life. Miracle pills, they are! I went from having to wear 2 Super Plus Tampons and a Super Maxi Pad (all at the same time) and changing numerous times per day - I would literally go thru 2 boxes of Pearl tampons (at nearly $5 a crack) to no tampons whatsoever, and maybe 3 pads per day (if that) But I digress.....so all along my insurance company has taken care of the majority of the cost - with me having to make a co-pay of about $40 per month. Long about Oct. for whatever reason - I was switched (by whom I don't know) to Balziva - which is the generic version of Ovcon 35. Not a big deal - and only $15 per co-pay! So along comes January. I am due for my yearly - and will be getting a new prescription. I procrastinate and cannot get in until Feb 1. Meanwhile, I need a refill on The Pills. I email Walgreens and they will take care of it. Then I get an email back saying that the insurance company is looking for what they call a "Prior Authorization". I have no clue what this is - so I am thinking that Walgreens is taking care of it. They are not. Apparently my Dr.'s office needs to fax something to the insurance company before they will "Authorize" it. Now did anyone inform my Dr.'s office of this? No. So a week goes by - I now need the pills - yet I cannot get them (unless I want to pay the full amount - which is $90 - FOR GENERIC!!!) Finally I call the Insurance Co. and they update me on what they need. I call the Dr.'s office - give them the fax # so they can fax "the form". Which they do - last Friday. Then again this past Monday. Still - nothing. I call the insurance co. yesterday - and after 20 minutes in their "automated system" I finally get to speak to a real live person! She says there has been nothing received - even though it has been faxed twice now. She sets up a "case number" so that it will be easier. At this point my appt. is the next day, so I'm figuring we will start from scratch. I have the appt. today - get the new prescription (and a free sample to hold me over). Take the prescription to Walgreens - who says they still are waiting for this "prior authorization". WTF??? I have never been in such a screwed up system as this. I can't even imagine what it is like for people with catastrophic illnesses who have to battle for their very lives. I mean, I know this is small potatoes, but it is so frustrating! They have been paying all along - and NOW they need to authorize it??? I know, I know "Thank God you have insurance.....many don't". I am thankful - and will be even more so when this gets taken care of. That's my rant - for today anyway

3 comments:

barefootblogger said...

I absolutely DESPISE those FUCKING AUTOMATED PHONE SYSTEMS! The only thing that AUTOMATICALLY happens when I find myself at the mercy of one is a FULL ON RAGING HEADACHE!

Give me a real person, ANY DAY!

LezBeBarefoot said...

You'd think with all the money we pay for insurance they'd be able to get their head out of their asses and actually DO something?!

Anonymous said...

Be careful of the generics....especially balziva...i've heard there is much more breakthrough bleeding with it. The new version of OVCON 35 is called FEMCON. Same ingredients as OVCON except you have the option of chewing it. Ask your OB/GYN for a sample and a new prescription.