Several weeks ago, I tried our new insurance company's prescription by mail service. I've always found ordering Max's anti-seizure meds in bulk to be a better deal than getting indie bottles from our local pharmacy. Besides, anytime I can have anything delivered, I am all for it. Like, if we ever decide to have that third kid, I am getting him delivered to our home.
The other day, I got a cryptic letter in the mail that said to contact the mail order company's Member Services Department. I call. The rep looks up the notes in the file and says that the pharmaceutical company does not have the medicine, Trileptal, available. That makes no sense, as this is a major medication, one used by more than one child named Max. Ten minutes later, she decides to get a pharmacist on the line. This is where the fun really starts.
I tell the pharmacist that I am not clear what is going on as surely, he would have checked whether it might be possible to get the generic form of the brand.
"There is no generic form of the medication," he says.
I am not convinced—both because Max's neurologist and I have talked about generic vs. brand and also, because as I'm on the phone with him, I do a Google search and find out that the medication went off patent two years ago and became available as generic.
I say, "I believe there is a generic kind of this medication."
He says, "No, there is not."
This is the opposite of helpful; even if there is no generic, what am I supposed to do? When might the medication become available?
I ask what the next steps are. The pharmacist says that I need to tell the rep how I would like to proceed. I say that I have no idea what he means. "The bottom line is, my son needs his medication. The risk for seizures isn't just going to go away."
The pharmacist repeats, "You need to tell the rep on the line how you would like to proceed." I say, "How I would like to proceed is, my son gets his medication!" And he says "You need to tell the rep how you would like to proceed." By this point, I am wondering if he is actually a pre-pre-recorded voice and whether soon there will be a "BEEP!" that sounds at the end of his sentences.
At last, the silent rep speaks up. "I have no idea what you want the customer to tell me," she says to the pharmacist.
Oooooo-K.
The call takes twenty minutes. Toward the end of it, by which point I am anxiously bending and re-bending a large paper clip, I ask the rep why they hadn't called me sooner. If we were going to have an inane conversation, the sooner, the better!*
(*I did not say that.)
"We tried your phone number a few times, then sent a letter," she says.
"I didn't get any voicemails—what number do you have?" I ask.
She reads a number that is a) the wrong area code and b) the wrong number.
She takes down the right number.
[Hang up, rip hair out.]
So today, I have to order the medication from the local pharmacy. Perhaps I can pick up some sedatives for the next time I have to call the prescription-by-mail "people."
At times like this, I wish I had a fairy insurance godmother. I used to. Months ago, I was given a trial membership to a service called Off Your Desk, a health claims company that handled insurance claims for customers. It was quite the pleasure to mail off bills to a rep, who followed up on claims/calls and got us some money back. That company was sold to MedClaims Liason. The fees are hefty, but may be worth it to people who have serious medical expenses or who have a low level of time, tolerance, and patience for dealing with medical claims and/or maddening insurance company staffers.
For now, I will be forced to waste precious moments of my life dealing with insurance company crapola.
I suspect you, too, have wasted more than a few precious minutes of your own life on similar calls?
BEEP!!!!!!!!!!!!!!!
istock/alexskopje
