health insurance companies obstruct patients ability to get meds..

[mdmc]

Recently I was prescribed a very expensive medication. My doctor wrote me the script, and faxed it to the required pharmacy. I never received the medication (available only through one mail in pharmacy). Confirmed the fax was received, but could not confirm the insurance companies authorization to ship out the medication..
It took me over a month to get the med - a month after it was prescribed.

I thought that what I had gone through to get the med was deliberate. It seemed that my for profit health insurance company was dragging its feet to save a couple $$$ by keeping me off my expensive medication for a month. Every penny counts, right?

Well here is a story / link that confirms that some insurance companies (Fox Health Insurance) do exactly what happened to me as part of their operating policy...
enjoy...

http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=3634&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date
MEDICARE ENDS CONTRACT WITH FOX INSURANCE COMPANY DRUG PLAN
...After an onsite audit, which ran between March 2 and March 4, CMS found Fox’s problems persisted and it continued to subject its enrollees to obstacles in getting needed and, in many cases, life–sustaining medicines.
...Among the audit findings CMS found include:

· Failing to provide access to Medicare prescription drugs benefits by imposing unapproved prior authorization and step therapy criteria that made it more difficult for beneficiaries to get drugs that are protected by law.

· Not meeting the plan’s appeals deadlines,

· Not complying with Medicare regulations requiring enrollees to be transitioned to new drugs at the beginning of the new plan year.

· Failing to notify enrollees about prior authorization and step therapy determinations as required by Medicare.

[county worker]

1. That step therapy is how they got me to pay for a drug out of pocket.

I had to have the nurse prescribe a different drug first and take it for 30 days before I could get the one the doctor prescribed. I could only get the doctor's prescription if I paid cash of $150 the first time.

[mdmc]

2. that makes me mad

:mad: