When health insurance hinders instead of helps

I’m not as young as I used to be.

So I visited my doctor, who prescribed me something to hammer out one of the dents in my fender.

That was Dec. 12. I’m still waiting on my medication.

Health insurance companies are to blame. For certain drugs, some firms require what is called a “prior authorization.” What this entails is having a physician send paperwork to the company, detailing his diagnosis and the patient’s need for a prescription.

By taking this extra step, the voices on the other end of the line tell us they are looking out for our best interests, making sure that drugs are precisely matched with ailments.

The reality is that health insurance companies are spineless cheapskates who relish sending customers down a rabbit hole.

Here’s the evolution of my odyssey.

My first prior authorization was denied. The paperwork “lacked a number,” they said. The second request was rejected, too. “Less expensive alternative” was the excuse.

So my doc writes another prescription and I wait. Lo and behold, that was kicked out, as well. “Insufficient documents,” they claimed.

You get the idea. Six weeks into this journey, I’m no better than when I started.

Keep in mind nobody is going to fight this battle for you. Your doctor and staff will assist but they are understaffed and overburdened.

It is up to the consumer to call the company, himself, and demand straight answers that cannot be found in the discombobulated language of letters denying coverage.

It’s a shame really. People pay decades of premiums, thinking they can lean on health insurance firms to help them out when the need arises.

But they have an agenda of their own. And it goes something like this: Confuse. Distract. Stall.

Their end game is to force you to give up.

I don’t plan to.

 

 

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2 thoughts on “When health insurance hinders instead of helps

  1. Rhett

    I always enjoy your pieces but I don’t understand why “big pharma” gets the headlines when clearly it is an insurance issue as your piece indicates.

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