March 19, 2002

Insurance Always Wins

I guess I should know better than to think an industry that makes billions of dollars, probably even trillions of dollars, by collecting money from me, the consumer, so that I won't have to pay money later in the event of needing a doctor, or medicine, or car repair, or whatever. If we all stopped paying insurance we'd probably save a lot of money in the long run, just like in Blackjack, where you don't get insurance unless you know what you're doing.

What has set me off on this particular PFFT! is medical insurance. I'm lucky in that my husband's insurance covers me at no additional charge to him, and he's on a PPO plan, so we can go see specialists without having to shell out for a copay and get lip service from some clueless, overworked PCP (primary care physician, for those of you lucky enough to not have to deal with HMOs). So that's good, although in this case both we and the insurance company do well, since I'm sure my husband's company pays good money for the PPO plan. This insurance also has a fairly good prescription coverage, although not as good as it used to be. It used to require a 10% copay of any prescription, which was great cause I would then pay about 50 cents for 2 month's worth of generic pills I take. Recently the insurance changed to paying 25% of name brand prescriptions, and at a $5 minimum for a month's supply, the cheap pills are no longer covered.

Now, I'm not going to get upset about having to pay $5 for my pills. What I do get upset about is the pharmacy refusing to give me 2 month's worth, even though it's on the prescription, even though it's coming out of my own pocket. The girl at the pharmacy gave some lame excuse about the insurance, but that's ridiculous cause they're not even paying for it! This was a while ago, and I'm sort of used to this. Yesterday it was a new one. I've been taking birth control pills for a couple of years. I've always gotten them in packs of three, which makes a lot of sense considering the directions specify to always have a spare pack on hand in case you lose them or forget to take a bunch in a row. Yesterday I was informed the insurance company will only pay for one month at a time, and they won't let me get my refill until the 4th week, so if I do lose them or forget to take a bunch in a row, I'm screwed and have to clear the refill with the doctor. This is absurd.

I can only assume the insurance company hopes I will decide to stop taking the pills this month, thereby saving them the 75% of the price they pay each month thereafter. I want to assure them that is not the case, and I will be on those pills for a long time. Of course, then they'll spring it on me that since these pills are not, strictly speaking, medically necessary, they will no longer cover them. Then I'll just have to get nasty. Greedy companies.. PFFT!

Published: March 19, 2002
Editor: stacy

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