I got new insurance this year.
Had an appointment at the first of the year. The office took a copy of my new insurance card. Saw the doctor. She prescribed 2 medications. One needed a prior authorization, the other was ready later that day. I picked it up. There were only 14 of 60 prescribed. I found out when I got home. Insurance wouldn’t fill more without a prior authorization for *that* mediation as well.
Called the doctor’s office. Oh, yeah, insurance companies need prior authorizations after the first of the year. Also, I screwed up by picking up a partial fill. See, this is pain medicine. They can’t just prescribe more. They can’t do anything unless I see them again. I get an appointment in a few days. The doc re-prescribes. They promise to do a PA.
It’s ready to pickup. I wait 15 minutes in line. I pay for it. Clerk asks if there are any questions. I check the count. It’s 14 again. I get shuttled to another window. I wait another 10 minutes. Pharmacist explains that it needs a PA. I tell them that’s what I thought I had. I return the partial fill on the spot, hoping this will keep the prescription active in order to get the PA sorted out.
I call the office again. They again claim I’ve got a PA.
I finally call my insurance. They claim they’ve never received the request.
It’s now past closing hour at the doctor’s office on a Friday. I’ve been out of pain meds for 3 days, and now have to wait the weekend.
Snowpocalypse. Everything is closed Monday.
Called the office on Tuesday morning. Point out that I’ve gotten new insurance, which they have on file, and ask if this is a problem. Yep. That’s the problem. She doesn’t admit where they screwed up, but the PA lady resubmits the PA, and claims it’s ready right now. “Go pick up your meds!” she says cheerfully.
If only.
I call Walgreens.
Now, understand that Walgreens will not let you call the pharmacy directly. The number for the local franchise goes through some horrible call center. It will ask you what you want. You have to say, “pharmacy.” Then it will try to convince you that it can help you, and you have to say “pharmacy” again. Then it tells you for the millionth time what the store hours are. Then it reminds you that if this is a life-threatening emergency, then what the actual heck are you doing calling us? *Then* you get a handler. *Then* you get to explain your situation. *Then* you get put through to the *actual* “dispensing” pharmacy. *Then* you get to explain your situation *again*. Then you get to be told that the PA is *still* not done.
I call the insurance company. They are actually helpful. They sort out the fact that they keep approving only 14. I’m told that they will now fill for 60, but that it will take 24-72 hours to go through the system. In today’s hours. Up to 3 days. In this era of instant global communication.
I call the pharmacy. I wait. I get hung up on. I get through. Not done.
Next day, I call the pharmacy. I get through. Nope. Call tomorrow.
I call today. I wait 5 minutes on the Walgreens line, and am dropped. I call again. I wait another 5 minutes, give the explanation, get transferred to the pharmacy. Get dropped. I call again. I wait *another* 5 minutes, I give the explanation *again*, I get transferred *again*, and… they still don’t have it.
Tomorrow’s the deadline of 72 hours. Trying to get this medication has taken almost 4 weeks at this point. Four calls to the office. Two calls to instance. I’ve lost track of the number of calls to Walgreens. Each time, I’m told to wait 1-3 days for this to “go through.”
Does anyone want to bet that the PA will have gone through by tomorrow, and I can finally pick this up? At this point, does anyone want to bet that this *won’t* require another call to insurance to confirm that it’s FUBAR’d, and that I have to have *another* doctor visit to start over from scratch!? Because not only do I strongly suspect this, I’m rapidly losing my will to live on this planet any more.
UPDATE: They did NOT have the PA. I finally asked if I could pay for it out of pocket. Yes. How much? $77. Wait. Let me apply a coupon code for you… $22. Insurance companies: What in the world are we doing here? Americans: Why are we putting up with this? Oh, right, because Congress does absolutely nothing to help people any more.