Saturday, April 2, 2016

New Insurance

The new policy year for my health insurance started April 1. While the medical coverage is the same, the prescription drug benefits are being handled by a new company.  I knew this.  I even went on their website to check if I could go to the same pharmacy for these drugs (which are considered specialty drugs).  The pharmacy was listed as in-network and the co-pay was the same as under the previous plan ($70).  Great!

So today, I bee-bopped into Walgreens to grab the two additional doses the doctor had called in yesterday.  I was looking forward to doing a little shopping after.  

"Your new insurance says that we are not an authorized location." 

"What?!  But I looked on their website ..."  Worry creeping into my voice.

"It's giving me a number for you to call.  We also have a discount program you could use.  These 4 vials would cost you $400 with that program."  She was trying to be helpful, but $400 is way different than $70.

"Uh ... ok ... let me go try to call them." 

I fast walked out to my car and called the number she gave me.  Apparently, it was for the specialty pharmacy for my insurance.  "Our office is now closed."  I was really starting to panic at this point.  I need these drugs.  So I called another number that I found on the back of my insurance card.  After several minutes of electronic prompts, I got a real human!  

"You have to get prior authorization for those drugs and you have to have them filled through our specialty pharmacy."

"Ok.  But I need these today."

She explained that I could get reimbursed this one time and that I should go ahead and pay out of pocket.  Whew!

Back into Walgreens I went (not bee-bopping this time ... I mean, $400 is still $400).  I tell the pharmacy tech the plan.

"Oh, you can't use the discount program with insurance.  It's one or the other."

"Ok.  How much will it be then?"

She literally whispered the number to me.
 "Oh my god ... (deep breath and resigned sigh) ... ok.  I have to get these."

So I swiped my AmEx and it was effing declined (!@#$%^) because the purchase amount was so large.  My phone immediately started buzzing.  Oh ... it's just AmEx asking if it's really me spending a cold hard grand at Walgreens.  So for the next several minutes, I stood at the pharmacy counter and said "yes" into my phone several thousand times until the automated voice was convinced that the purchase was not fraud.

Biggest purchase I will ever make at a drugstore complete, I went back out to the parking lot where I sat in my car and cried and called Mike and cried some more.  I know I will be reimbursed, but they're my hormones and I'll cry if I want to.

To make myself feel better, I bought myself this cat planter from West Elm.  And I totally deserve it.


  1. You totally deserve the cat planter! Insurance companies and all the hoops they put you through suck! Kudos to you for staying (mostly) calm!

  2. You DO deserve it, and it's so cute! <3