Tuesday, March 27, 2012

Winning the Bureaucratic Battle

My husband's employer's insurance company decided to present my husband's employer an offer they couldn't refuse.  They, the insurance company, said if you can get all of the cover people to use "X Company" to get their regular maintenance medicine through the mail it will be cheap for you, my husband's employer.  Sounds great right?  Lower prices for medicine to all the employees :)

Well, that is fine and all for the medicine that doesn't prevent cancer!  
Here is my issue, if a manufacturer states on the prescription instructions that this medication must remain between Y and Z temperature to remain effective... then it MUST!  Well, if you ship through the mail then the medicine it is NOT maintained between Y and Z temperature.  There is no way to guarantee that it will stay between Y and Z.  So, in my case, the Levoxyl will not be effective.  Um, that is not cool for a cancer preventing drug to be ineffective, right?  The insurance company says that there are no exceptions unless you go through filing a grievance.  

So, I file the form along with the manufacturers instructions and my Doctors expertise on the matter.  A few days later I received a letter from the insurance company stating that the claim was denied and that I could appeal further with more support if I wanted.  Are you kidding?  The manufacturer stating the medicine requires Y to Z temperature and the Doctor explaining the ill-effects on the patient of not having effective medicine leading to the recurrence of the cancer is not good enough?  

Well now I am distraught.  If I don't get the medicine from my local pharmacy then do I know that it is working correctly?  Well no, not until it is too late and I am not adequately suppressed.  SO, I am still battling on with the insurance company.  I am trying from my husband's employer side of things, too.  Maybe there will be an exception maybe not.  Regardless, I am also working on a way to get the medicine through the local pharmacy without the insurance.  My pharmacy has a group discount card that I used once. It was actually cheaper than paying the co-pay for the insurance :)

I say don't take the blah, blah answer, fight and win!  If we all just start rolling over for the insurance companies, then we all are getting robbed blindly and taking risks by trusting they are doing things in our best interests or just to save a dime.  I was raised to find the truth regardless and stand up for it even it costs more... I will and I will survive.  God willing these companies will see the error in this policy and that peoples lives are at stake.