Tuesday, June 2, 2009

It's All In The Wording...

...Or BCBS sucks.

I’m currently on COBRA insurance. It took three months to activate, then became retro-active.

During this three month period, I started Novolog. My endo wrote me an rx for Novolog pens, indicating I was to take “about 20 units a day.” My CVS pharmacy did the math and figured out that a box of Novolog pens (five per pack) was equal to 75 days at 20 units a day and wrote that down in my “official” prescription information. I paid cash ($200+) for the insulin.

When my COBRA activated, I submitted all my prescriptions for reimbursement, like I’m supposed to. However, turns out my insurance company doesn’t like to pay for anything that’s over a 30-day supply. The $200 is non-reimbursable (it’s a word now). BCBS explained that they will cover the Novolog in the future, if the prescription is written differently so it only comes out to a 30-day supply.

I have an endo appointment on Friday and, in addition to discussing the many important facets of my new insulin regimen, how my sugars are reacting, what I’m doing right to keep myself alive and healthy, what I’m doing wrong that will possibly endanger me for the future, I will have to take time to explain to her that BCBS does not like the way she writes prescriptions and ask her to give me a new one that specifically says, “one box of pens for one month usage.”

See alternative title above for summary of situation.

As always, more to come…


CALpumper said...

Insurance companies SUCK ASS.


Sorry they gave you the run-around. UGH! Get it Right America! Sheesh.

wv: takie

Uh huh. Insurance companies love to takie takie from us, all the time, yuppers.

Jonah said...

I have BCBS-IL PPO and they have their own mail in pharmacy from which I get Lantus and Novolog in 90 day supplies (one box of Lantus pen cartridges and two boxes of Novolog pen cartridges).

Tim said...

After reading posts like this, I wake up every day and thank God we have the NHS over here in the UK.

I agree with Call up there, insurance companies do suck ass (yuk!) and I'm glad I hardly have to deal with them and certainly never for health-related stuff.