Fuckin health insurance companies

[Tobin S.]

I have a few medications that I have to take every day that are necessary to maintain my well being. They are somewhat expensive. Without prescription coverage they cost about $350 a month. I have not had employer subsidized health insurance for almost a year and a half now, but I do have health insurance on a COBRA plan. I just got notice that my COBRA plan will expire on 12/28/11.

I will not have health insurance with my current employer until 3/1/12. I started on that date earlier this year, but my employer requires a full year of employment before they grant health insurance. That's a shitty policy, but the company is decent otherwise and they provide me with a few other things that I really need that are in low supply in my hometown- like a truck driving job that's first shift and gets me home every day to be with my new wife.

On my current plan they have mail order prescriptions. I have to comply with that instead of getting my prescriptions at a regular pharmacy seeing as how my prescriptions for the same medication is ongoing. They fill the prescriptions for three months' supply at a time. I just got my latest prescription filled in October, but they dragged their feet for a couple of weeks. At first I didn't know why because they usually filled them within a few days of my doctor sending them into them and that is all done electronically on the day that he writes my prescriptions.

I had an idea of why they might be dragging their feet and I confirmed it yesterday when I got the expiration notice and then looked on my prescription bottles for when I would be eligible for my next refill. That day would be 12/29/11. :mad:

So they stalled on the refills just long enough so they would not have to give me another three month refill before my COBRA plan expires, which would have held me over until my new insurance kicks in.

[elleng]

1. Damn game playing, Tobin.

Any benes available through spouse? (You HAVE one now, ya know!!!)
:hi:

[Tobin S.]

3. Coverage for me through Jen's workplace is $700 a month

Yeah, really. For her alone it's not bad.

[Amaril]

2. Call and complain

Call them and scream bloody murder. Absolutely NOT a good business practice, and in some states they could be looking at a hefty fine if it is found that something sketchy transpired (which it sounds very much like it did). Tell them that unless they give you another full refill -- which you would have been entitled to prior to the date your coverage is set to lapse, but now will not receive due to THEIR failure to issue your last refill on the date it should have been done -- that you will file complaints with every single governing agency you can think of, and that you won't stop until someone corrects the problem or you feel that you have been a sufficient pain in their ass. And, frankly, I would state it just like that, and then follow it up in writing -- leaving out the threat of ass pain, of course -- telling them exactly what you want. Send it by certified mail.

If that doesn't work, then start filing complaints. Start by filing a consumer complaint with the insurance commission in your state -- every state has one, they just go by different names & fall under different agencies (for example, in Florida, insurance companies are governed by the Department of Financial Services, which is headedup by the state Chief Financial Officer -- an elected official). I would also file a complaint with the Consumer Fraud Protection division of your state Attorney General's office, send letters to your state congress critters, the Federal Trade Commission and the Better Business Bureau for good measure. If any of your local TV stations have a consumer watchdog, call his / her office and tell them your story -- sometimes they can be more effective than all the governmental entities combined.

Good luck! Sorry they're screwing around with you. I second your :mad:

[Tobin S.]

4. Thank you, Amaril

You know it didn't even occur to me that I could do something about this or that they might have done something illegal. That's probably something that they bank on- literally.

[elleng]

7. Right, Tobin, they probably do 'bank' on it,

and most probably do the same. Good advice from Amaril.

[Gormy Cuss]

16. Tobin, before you start complaining have all of your ducks in a row.

That is, have the dates for past refills in hand and your best estimate on how long it took to refill each time.

Complaining only costs you your time and maybe a little postage. Well worth it if you can get that next refill.

[suninvited]

5. That is low, but hard to believe somebody was paying that close

attention to the dates to time your medicine refills to not be covered next time. Who would have done it? The insurance company, the doctor, or the pharmacy? The doctor and the pharmacy have no incentive to see that your medicine wont be covered, and I am not sure the insurance company can stall your medicine. Might just be an unhappy coincidence.

My current job said I would be eligible for health benefits after one year of employment, too, but, I still have to wait until the first open enrollment AFTER my one year anniversary. They didn't tell me that when I was hired, which actually means I will be one and a half years without insurance and I cant actually enroll until May. If you aren't put on an insurance plan within the first thirty days of employment, you usually have to wait until enrollment to enroll. Make sure you check on that so you don't have any surprises in December.

What about your wife's insurance for the meantime? You can be added outside of open enrollment due to marriage and when you get covered you can drop it from hers.

[Tobin S.]

8. I don't know how closely the insursance company

and pharmacy work. I think it's possible that the insurance company would not pay for their portion of the claim until a certain point, but I don't really know. I guess it could just be a rotten coincidence, but it sure looks fishy.

I can get insurance through Jen's plan but it would cost me about $700 a month. It's not bad for her alone, but she doesn't get any breaks for a spouse or dependents.

[suninvited]

10. I would call the pharmacy first and find out the procedure

tell them that your refill dates look funny and ask for an explanation. What caused the delay?

If your medicine is filled bi-monthly and is due to be refilled on the 10th but it isn't filled until the 15th, would the next refill be on the 10th, or the 15th? See if the date can be changed in the computer. If that doesn't work call anybody and everybody who is involved until somebody will do something about it.

[whistler162]

6. Have you talked to your doctor(s) about a script

for 90 days worth of meds?

[Tobin S.]

9. That's what he writes it for every time

Ninety days per script with three refills.

[RebelOne]

11. I don't what kind of meds you are taking,

but you could order a one-month supply through a Canadian pharmacy to tide you over until your new insurance kicks in. And you do not need a prescription. Here is the one I order my blood pressure meds from.

www.family-online-pharmacy.com/purchase_blood_pressure_generic/

[barb162]

13. I find the Canadian pharmacies have pretty good prices also.

Good point.

[Name removed]

12. Deleted message

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[csziggy]

14. What state is the mail order pharmacy in?

If it's Texas do file a complaint. I had a problem with a previous insurance company's mail order pharmacy incorrectly filling a prescription (generic which I could not use instead of the brand name the doctor specified) but refusing to refund my money. I put in a complaint with the Texas governing agency. It took a while, but months later I got a check in the mail from the pharmacy.

[Callalily]

15. Can you ask your doc

to write a prescription for one month and submit b/4 your insurance runs out?

Yes, do complain, rant, rave too!

Good luck.