Today's post is brought to you by the big ol' glass of haterade I drank earlier. Yes, I've got my hate on right now. It looks good on me, yes? It's rather slimming, I'd say. But why have I caught the hate? What has made it course through my veins like the venom of a vampire in a Stephenie Meyer novel? Two words: Insurance Companies.
Did you know that insurance companies all know you better than your doctors know you? And, even more incredible, apparently they even know you better than you know yourself! This must be the case since they have the God-like power of approving or denying anything medically-related under the sun. If they disagree with the doctor on your course of treatment, they, in all their medical knowledge and glory (praise be the Lord of HMOs and private insurance companies, hallelujah!! can I get an AMEN?), can say "Nope! Too bad! Too expensive! I know you pay over $500/month in insurance premiums to cover these kinds of things, but I'm saying no! Nanee nanee boo boo on you!"
I saw my doc today (that was a whole other debacle which I think will have to wait until tomorrow because right now I'm too focused on my crappy insurance company) and we discussed the best course of action for all of the symptoms I've been having. He didn't want to prescribe much without knowing what my blood work was looking like, but he did want to address the biggest issue I've been having which is lack of sleep. OTC sleeping pills don't help at all, the muscle relaxants that we tried most recently didn't help me sleep but made me feel whacked out the next morning, and he wants to see if the lack of sleep is causing my pain which then causes me to not be able to sleep due to the pain which is therefore causing more pain (vicious cycle anyone?). It's possible that I'm just having bad fibromyalgic pain that's causing the lack of sleep which is causing the pain to be worse (notice anything familiar about this vicious cycle??)... either way, we have to pick one thing to address and so Dr. T decided to try working on the sleep issues first to see what happens. As such, he prescribed me Lunesta. We've talked about this prescription a few times in the past - we decided against Ambien because of a bad prior experience - and there were two others that he mentioned but because I have some fluid retention issues he didn't want to do one of them (fluid retention was one of the side effects) and the other one he didn't like to prescribe to lupus patients because of the potential for bad side effects.
So he writes me the script, sends me down to the lab so thevampires phlebotomists can take the lovely 9 vials (8 big ones and 1 small one wheeee), and sends me on my way. Once I'm done at the lab I drive all the way home and go to the Walgreens that's just down the street from my house. I drop off the prescription and wander around the store waiting for them to call my name when my prescription is filled. About 15 minutes later I hear my name over the loud-speaker and go back to the pharmacy section where the pharmacy manager proceeds to tell me that my insurance will not cover a dime of the Lunesta but if I want to pay for it out of pocket, I can. The cost? $212 for a one-month supply. **jaw drop** I figured it would be a Tier 3 drug, meaning the most expensive co-pay possible, but I never expected them to outright deny it. So when I ask why they denied it, I'm told "Well, they feel there are other, better, and cheaper drugs out there that you can take instead." I'm so glad that they were able to make such an important decision without looking at my charts, my medical history, or talking to the doctor. I'm also glad that they were able to make such an important decision without even having a medical degree! Hot damn, I'm in the wrong field!! I wonder if they get a kick-back for every denial that saves the company money... **mutters**
I'm going to call Dr. T in the morning and the pharmacy manager also said that he would fax something over to the doctor, as well. We had already decided today that if the Lunesta didn't work for me that we would try Cymbalta or Lyrica - I guess if we can't get the Lunesta through insurance we can try one of those and see if either of those will work instead. But seriously, what is it with people with (likely) no medical training being allowed to make these kinds of decisions? Do they really think I WANT to pay a ridiculous amount of money for a drug that may not even work? Even on the highest tier I could spend up to $75 out of pocket - that's a lot of $$ for a one month prescription - do they honestly think I would choose the most expensive drug out there?
Grrrr! I was so excited to possibly get a real night's sleep for a change... and now the rug's been yanked out from underneath me. Poopieheads!!! Maybe Dr. T will be able to talk some sense into them... I doubt it, but there's that little glimmer of hope right there in the outer reaches of my mind.
Here's to hope... **tips her wine glass since she has nothing else to attempt to try to help her sleep at this point**
Did you know that insurance companies all know you better than your doctors know you? And, even more incredible, apparently they even know you better than you know yourself! This must be the case since they have the God-like power of approving or denying anything medically-related under the sun. If they disagree with the doctor on your course of treatment, they, in all their medical knowledge and glory (praise be the Lord of HMOs and private insurance companies, hallelujah!! can I get an AMEN?), can say "Nope! Too bad! Too expensive! I know you pay over $500/month in insurance premiums to cover these kinds of things, but I'm saying no! Nanee nanee boo boo on you!"
I saw my doc today (that was a whole other debacle which I think will have to wait until tomorrow because right now I'm too focused on my crappy insurance company) and we discussed the best course of action for all of the symptoms I've been having. He didn't want to prescribe much without knowing what my blood work was looking like, but he did want to address the biggest issue I've been having which is lack of sleep. OTC sleeping pills don't help at all, the muscle relaxants that we tried most recently didn't help me sleep but made me feel whacked out the next morning, and he wants to see if the lack of sleep is causing my pain which then causes me to not be able to sleep due to the pain which is therefore causing more pain (vicious cycle anyone?). It's possible that I'm just having bad fibromyalgic pain that's causing the lack of sleep which is causing the pain to be worse (notice anything familiar about this vicious cycle??)... either way, we have to pick one thing to address and so Dr. T decided to try working on the sleep issues first to see what happens. As such, he prescribed me Lunesta. We've talked about this prescription a few times in the past - we decided against Ambien because of a bad prior experience - and there were two others that he mentioned but because I have some fluid retention issues he didn't want to do one of them (fluid retention was one of the side effects) and the other one he didn't like to prescribe to lupus patients because of the potential for bad side effects.
So he writes me the script, sends me down to the lab so the
I'm going to call Dr. T in the morning and the pharmacy manager also said that he would fax something over to the doctor, as well. We had already decided today that if the Lunesta didn't work for me that we would try Cymbalta or Lyrica - I guess if we can't get the Lunesta through insurance we can try one of those and see if either of those will work instead. But seriously, what is it with people with (likely) no medical training being allowed to make these kinds of decisions? Do they really think I WANT to pay a ridiculous amount of money for a drug that may not even work? Even on the highest tier I could spend up to $75 out of pocket - that's a lot of $$ for a one month prescription - do they honestly think I would choose the most expensive drug out there?
Grrrr! I was so excited to possibly get a real night's sleep for a change... and now the rug's been yanked out from underneath me. Poopieheads!!! Maybe Dr. T will be able to talk some sense into them... I doubt it, but there's that little glimmer of hope right there in the outer reaches of my mind.
Here's to hope... **tips her wine glass since she has nothing else to attempt to try to help her sleep at this point**
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