I’ve been taking 10mg a night of a certain medication for years . Recently my doctor changed my dosage to 20mg a night. Last month the prescription went through with no problem. However, this month, when my pharmacy checked to make sure my meds would be covered by Medi-cal the prescription was denied. Several calls to the pharmacy didn’t do any good. Their hands were tied.
Maurice started calling Medi-cal. When he reached them he was told that I had to reach a $900 co-pay each month before they would pay for the prescription. $900!!! After I pay child support I don’t even have $900 to live off of. Well, according to Medi-cal, they based their rates on the cost of living. Apparently it was determined that I can live off of $600/mo. Now, I don’t know where you all live, but I can’t think of anywhere in the U.S. that I could live off of $600, and I’m in Los Angeles for God’s sake.
Well, Maurice made some further calls and we finally got to the root of the problem. The problem was not the prescription, nor did it have to do with some magical, out of nowhere $900 co-pay. The problem was the amount of pills in the prescription. Medi-cal would not pay for two 10mg night pills, but they do cover one 20mg night. This is insane!
Fortunately the pharmacy knows me and they’re always good to me. Knowing it was going to be next to impossible to get a new prescription from the doctor at 4pm on a Friday, they went ahead and gave me enough pills to get me through the weekend.
I understand that government agencies are not required to operate under logic or reason, but come on, at least try a little bit. Thank you CVS pharmacy for taking good care of me.
2 comments on Brads Rant Of The Day
Insurance companies never make any sense. When I injured my ankle and was dealing with the pain…I never took any strong meds…just anti-inflammatories (over the counter) After 6 months to 9 months of the my doctor said she didn’t want me taking the pills anymore cause of long term health issues and she prescribed a cream that I could put on the ankle directly so no pills in my system. The insurance said no. They didn’t care about my health…they cared that the cream cost $250 a tube. It wasn’t about patient care…it was about the bottom line. Imagine all the money they would have had to spend if I had taken the prescriptions for the heavy pain meds instead of the Advil. Sigh.
I get what you’re saying, London. I hope to see us have Universal Healthcare in my lifetime. Sure I made a nasty comment about the government in my post, so it may seem contradictory. However, I have a friend who’s a doctor in Canada and one in the U.K. Both said there’s a lot of bad things you can say about socialized medicine, but neither could imagine turning a person away or denying needed medication. The concept was very disturbing to them.