"I have never felt that anything really mattered but the satisfaction of knowing that you stood for the things in which you believed and had done the very best you could." - Eleanor Roosevelt

Monday, July 23, 2007

Rant, as promised

Okay, I eluded to a rant in my first post today. Take a deep breath and hold on. I will apologize in advance for anything that I say that offends anyone that is 1. Not dealing with menopause, 2. Not dealing with Insurance, or 3. Works for Insurance.

Friday, Munchkin and I went for our annual well woman check ups. I love, let me repeat, love my OB/GYN. Dr. Paul I. Cook is one of the sweetest doctors I have ever had. He has helped me with many major female health issues and always considers himself part of my team and not the sole authority. We have always developed a plan and then openly discussed the pros and cons and worked for a solution that I can handle and that is medically sound. He knows my family history (mother with mastectomy, aunt that died of breast cancer after a double radical mastectomy, etc....) and he also knows my current family situation and loves Wifey (btw - Mafia - thanks for that term)! I also forgot to mention, he graduated from the same High School as Munchkin and Trouble.

With that foundation laid, we arrive for our appointments. For those of you with menopause issues, you will understand the next few lines. For those of you not quite there yet, be patient, your time will come. Due to my mother's cancer, I knew that I was going to have to discontinue my hormones when the prescription ran out (June 7th to be exact). Again, for the rookies, this is bad for all people involved. When you have no controlling agent, you quickly can become Jekyll and Hide. I had a list of issues/concerns and after the exam we always visit in the conference room to talk about the visit, the family, and when we can play golf together.

After our visit, he gives me three prescriptions. One is for Boniva, one is for Lexapro, and the last one is for AmBien. Now, keep in mind, I HATE taking meds. I loved the Femring because I put it in and it lasted for three months. No taking pills every night/day. Simple. Easy. After discussing my options, he gave me these for the following reasons:

The Boniva is to prevent osteoporosis. Enough said. The Lexapro is an antidepressant. When you don't have hormones, you suffer from anxiety and this will help. I'm not depressed, but I do have anxiety attacks sometimes (only two since June 7th). The AmBien is for sleeping. Another benefit of menopause is you don't sleep well.

What is the rant you ask? Okay, you asked for it. Wifey and I went to Wal-Mart to get the AmBien and the Boniva filled. We agreed that I am okay for now with my eating program and the yoga, so we will hold on the Lexapro. I drop off the prescriptions and the nice young pharmacy person tells us it will be 45 minutes. Not bad, and we had shopping to do anyway. As we wandered around getting the stuff on the list, Wifey hears my name over the intercom asking me to report to the pharmacy.

Oh yes, can you see it coming yet? I get there and I am directed to the counseling window. The Pharmacist comes to the window and first tells me that the computer is telling her that I am trying to re-fill the AmBien too soon. I get surly (irritably sullen and churlish in mood or manner) and tell her that I HAVE NEVER had a prescription for AmBien and that she needs to look at the computer again. She then actually types my name in her magic machine and tells me that Humana doesn't want to cover either prescription because I am not old enough to need them. Really! They have seen my medical chart? They have been to medical school? They are keenly aware that I have had a hysterectomy? I am starting to get a bit short when Wifey steps in and asks what we can do. The Pharmacists tells us that she will have to contact Dr. Cook on Monday (07/23/2007) to get him to call the insurance and tell them why I need these medications.

Why does my doctor need to justify his work to the insurance company? If it was a prostrate problem, by God it would be fully fixed and covered. I am still seething about this. If you work in the insurance field, can you please explain the rationale behind wasting my time and the doctor's time? I realize that some people do abuse the system; however, this is an injustice to the doctor's education. of course, Dr. Cook has already called and assured me that he will get it all straightened out. I wish that everyone had an OB/GYN like him.

Back to your regularly scheduled program....

3 comments:

Michelle said...

F*in insurance companies... Don't even get me started on health care companies and the American health care system! You will get the liberal in me all stirred up!

Miss Me said...

sometimes i'm just glad that i live in canada! not that our health care is terrific - just different... and you're right - if it was a 25 year old man with a prescription for viagra, it would have been filled no questions asked!

Megan said...

I will never forget the day I went to fill my birth-control prescription and was told by the pharmacist that my insurance company no longer covered that and I would have to pay full price, out-of-pocket. I actually burst into tears at the utter absurdity. They still covered Viagra and abortion. Does that make sense to anyone?!?