Friday, January 29, 2010

Errrrr I hate Insurance Companies!

I just spent 4 days fighting with my insurance company! Apparently at the first of the year our insurance plan changed and they decided that they were not going to pay for one of my medications anymore, but no one told me this!! So I call and order a refill for my 3 month supply, that I have been getting through the same company for the past year, not thinking anything of it I just placed the order. Today I get a call from a lady at the insurance company. "Mrs. Evans I'm calling from Express Scripts to get authorization to ship your order out. The reason I need authorization from you is due to the amount that will be invoiced to you. The total will be $1,056.00."

WTF!! For the past year I paid $110.00 for this EXACT same 3 month supply! Seriously I have been on the phone ALL day long. My Dr. sent a letter to the insurance company last year stating that he needed me to be on the name brand medication instead of the generic. The insurance wanted me to have the generic so I had this same fight with them around this time last year when my husband's company switched to them. Finnally they get it right and have been giving me the correct perscription for the whole year of 2009.

However, apparently after the first of the year my insurance plan changed and decided that if my Dr. says I need the name brand instead of the generic I have to pay my co-pay AND the price difference between the name brand and generic.
Ummm Hi, isn't that the same as paying full price?!?!? What is the purpose of insurance if I am paying full price!?!?! They are telling me that now they need a letter showing "medical neccessity" from my Dr. Apparently this is different from the letter he sent last year saying I need to be on this medication. Now they want him to "prove" that I need to be on this medication! Seriously! I don't get it. I honestly don't get how insurance companies can do this. When your Dr. is saying you need a medication isn't the purpose of insurance for them to help you get that medication at a discounted rate??

I know insurance companies have lawyers that probably go over these kinds of policy changes, so I don't know if any of this is actually illegal or agianst my rights. But you can bet that come Monday morning I will be call PrePaid Legal just to double check!!
PrePaid Legal Services Inc

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