I had a rant forming and so headed to this area of the forum and found this thread. I live in the USA so my issue is very similar but nuanced a little differently. I take a lot of medication for asthma, diabetes, gout, severe allergies, mild depression and the various other occasional infection or injury. We have a new healthcare system which I worked long and hard to help get into place. Our pharmacy costs are skyrocketing. Every year in January our plans change.
I care for my mother who has dementia-she also takes several medications. We use the same health insurance company but because of our ages the same plan is not available to both of us. We have different preferred pharmacies for our healthcare plans. We use trips to the pharmacy as outings-we try to go somewhere at least once a day. Yesterday I went to collect my insulin which I had waited to order because my insurance would not cover it until yesterday-they thought I was using too much? When I was checking out the clerk informed me that my they were no longer a preferred pharmacy for my insurance plan. Mind you I had been in two days before to pick up other medications and they had not said anything about it-only that my insurance wouldn't cover my insulin until January 10th. So she could not fill my prescription. Actually the way it's supposed to work is they fill it and I have to pay for it if my insurance doesn't cover it but she knows me and knows that I will not pay $2465.84 for insulin-which is what they are charging my insurance company. She suggested another pharmacy across the street.
My blood sugar was low because we had just come from exercise class. I told her I would call my insurance company and find out which pharmacy was on the preferred list now and have my prescriptions transferred.I tested my blood sugar there in the waiting area, bought some chocolate milk and cookie for mom and treated my low. I called my insurance company. They informed me that CVS (the pharmacy) had dropped the contract for my plan. Yes, I'm naming names on the blood sucking profiteers. My insurance company is complicit though because they changed me to a different plan starting January 1st even though I asked to stay on the same plan which was continued. The insurance company apparently segregated high usage customers into a separate plan so it was easy for CVS to continue contracting to provide for lower usage customers who let then auto-fill prescriptions and dissect the lower profit customers. I have opted to order my medications as I need them and manage my copays and collection times to fit my care schedule and budget.
The customer service person on the phone at my insurance company was very helpful after I reached her. I had to hold for 20 minutes before reaching her. This is apparently happening to a lot of people this week. She suggested two pharmacies within reasonable distance that are on the preferred list now. I chose one that I already shop at for other things. The insurance customer service person actually called them and set up a transfer of all my medications. The pharmacists from the two pharmacies had to communicate to complete the transfer and this took a few hours. I took mom grocery shopping while we waited. I went to pick up the insulin again. They wanted a $100.00 copay at the new pharmacy. I did not have $100.00 available to pick it up and asked them to hold it until today. I told them I did not have $100.00 copays on my plan-they are $5.00 or $15.00 as stated on my insurance card. The pharmacist suggested I call my insurance company again. I told her my cell phone was dead and she let me use their phone. It was dinner time by then and mom was tired and hungry. The insurance company put me on hold again, mom had an accident, and my frozen food was melting. I told the pharmacist I was going to hang up that it had taken 45 minutes on the phone earlier and I needed to go feed mom.
I went home and charged the phone, transferred money into my account to pay for the insulin and gave mom a bath and fed her. It is the next day, my blood sugars are running high and we are going to get my insulin again as soon as mom finishes eating lunch. I will call the insurance company after we get home or tomorrow.
My insurance company customer service people are very helpful and nice but this is exactly why I wanted a single payer system. My monthly insurance copay is over $2000.00 per month but I get a tax subsidy that pays most of it. I should not be having to run around for three days trying to get my insulin prescription filled. There were several older people at the new pharmacy shocked by their new copays also and struggling to buy medicine and food-that's the thing with insulin-you have to eat with it or it will result in low blood sugars that can kill you or result in brain damage-Don't take it and you get high blood sugars whether you eat or not and diabetic complications or death.
It seems the pharmaceutical companies are actually the villains here-who knew they would take advantage of a captive, contracted market to skyrocket their profits? The insurance companies are taking advantage of the situation for sure but they are at least trying to help people get care-the pharmacies seem to be trying to make life saving medications out of reach to those of us who need them.
I strongly support Obamacare-it was the best we could get through at the time and we had been working to get healthcare for everyone for so long-but the pharmacies and insurance companies need to be reigned in- you can not scrap this system and start over because we are dealing with many fragile lives here-some people simply can not go without their medications and live. Coverage needs to be continuously maintained for people to live and reduce complications from their chronic illnesses-we are talking about almost everyone's grandmother and grandfather, or mother and father, or child. We will have far more cost to the American healthcare system if the healthcare we have now is denied to those with chronic illnesses.
Okay rant over, I am going to pick up my insulin now.
