Preventing Health Care

To the doctor with the end result, some RX scrips for the pharmacy.  That was once a simple task.

The new prescription plans run by, large mail order prescription drug companies under the auspices of employer sponsored health programs are a bit different, and they are a part time job without pay.

We pay a higher co-pay for branded prescription product.  However, it still comes at a higher price all the way around.

Therefore, even though you, and your health care professional have considered the options, and decided on a product with a written prescription, the insurance plan would like one more shot at the lower priced product.  So, they will deny authorization to fill the prescription, denying immediate health care. They will demand ‘pre-authorization.’ 

Bottom line, it is the insurance company’s last shot at direct communication with the health care professional to possibly change the prescription to a less expensive product.  They don’t budge until they have ‘pre-authorization.’ They prevent you from getting medicines as necessary, in a timely manner.  Preventing Health Care.

It is not as simple as the doctor merely verifying it is, indeed the necessary medicine for your health.  No, verification is only the beginning.  They have to ‘build a case.’  You can drop dead first but, ‘the case’ must be built. 

Build a case?  ‘Well, yes, of course, a case has to be built.’  ‘Besides, you can just buy the medicine, and when it’s approved, do the necessary claim for reimbursement.’  No thanks.  That is just more paper work compiled upon more work, and a breach of my time.

Maybe in angst I relent, and purchase the medicine outside the plan.  Do I become too busy to do the paper work for reimbursement?  It is something I have the best of intention but, in reality no time to offer the task?   Another way insurance companies capture some free dollars to the bottom line.

‘Sorry.’  Bet they say sorry, many times in a day, indicating anything but, favorable customer service.  It is really too bad because, those are just people on the other end of the line.  They have to do their jobs. Unfortunately it is not easy when, by policy, you can’t give good customer service, working in an unpopular job, preventing health care.

So now, health insurance plans have begun aligning in the name of, ‘Preventing Health Care’ for which we pay the same premium as if we did have timely, health care.