Health Insurance Rant

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BethM

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Ok, I just need to rant about my health insurance.

I went to fill my allergy prescription today. I have $48 left in my flex account, and my allergy Rx is $30, so I also requested a refill of my birth control. I use the one that is 3 months and then the week of "blank" pills. My Dr. gives me the free pack so I can just skip the blank pills and never have my period. I have been using this BC for 3 years, and it's great.
I have always had *terrible* periods, awful cramping, heavy flow, mood swings, bloating, you name the PMS symptom, I had it. I tried at least half a dozen different pills, and all of them gave me nasty side effects until I tried Seasonique. No more side effects!

My work used to have Cigna, and with them the 3-month pack was $60. In 2007, we switched to Blue Cross, and the price went down to $50 for the 3-month pack.

Today, when I went to pick up my prescriptions, they were asking $150 for *just* the BC. :shock: I didn't pay for it, went home and gathered up my insurance paperwork. I went back to Walgreens, and made them call the ins. company. The lady (or guy) at the other end of the line said that since it's 3 months' worth, I have to pay 3 co-pays for it. I told the clerk that I have never had to pay that much, which he relayed to the lady. She asked when the last time I had refilled was, and he looked it up and told her, August. (He gave her all my info, she was probably looking at the info when she asked.) She replied that they changed their policy in September.

I NEVER got any notification of this "policy change." Also, since our plan year is Feb. 1 through Jan. 31, we JUST had our open enrollment at work, and I compared the drug list booklet that I was just given (and is indeed dated Sept. 1, 2008) to the one I was given the previous year, and the policies in the beginning are EXACTLY THE SAME.

So, I don't know what I'm going to do. No other pill that I've tried has worked for me without bad side effects. I think there is a generic available for this one, but I've never read a review of it that didn't say "...I switched to the generic and bled continuously for 5 weeks..." or "...when I switched to this generic I vomited and had diarrhea for a week, and it stopped when I stopped taking the pill..."
I cannot afford $50/month for this. I had less withheld this year for my flex spending, as I am not planning on having any special procedures done this year, and our enrollment was a week and a half ago. Since I didn't know about the "policy change" I was not able to compensate for the price difference.

I'm not sure what I am going to do. I cannot afford this, and I've never tried another pill that worked for me. I guess on Monday I will have to call my doctor and ask for suggestions. If there is no way for me to get this BC for the same price I have been paying, I guess I will have to stop taking it. My husband will have to consider The Big Snip, or else find some alternate, um, interests. I do not want kids. Ever. Even if I did want them, I cannot afford to have kids. There will be NO activities that could result in kids. Plus, he will have to deal with moodiness and depression (more than usual, I have a bit of both of those anyway), and I will end up missing a lot of work because of the terrible periods. (Seriously, the pain is that bad.) I guess, though, that will save me time and money from going to the OBGYN once a year. I don't see the point in going if I'm not going to be getting a BC prescription. It's too much of a hassle to get an appt and then get time off work, and then the nurse says I'm "getting to be the age" to have a yearly mammogram. (Wait, I'm only 33, a yearly mammogram isn't recommended until over 45, because before then it actually *raises* your risk of some things. Does she live under a rock, or is she trying to make money off me???? I have no family history of breast cancer.)


*sigh* This is how my life goes. Every single time something goes right for awhile, it all gets screwed up somehow. I get a bill paid off, or a bit of money saved up, then there's an unexpected expense that wipes it all out, and usually plus some. I've only owned 2 cars in my life, I drive carefully, and both cars have had cracked windshields. (Can't afford to replace the current one, either.) I have 2 computers, the laptop needs a new DC jack, and the desktop reboots itself if the front USB port is touched by anything. I work my butt off, rarely miss a day or even take vacation time, but get the smallest raise in my department (less than people who mess around half the day or continually make huge mistakes), and am passed up for promotions.
My whole life has been like that. In college, I got better grades than all my friends, and worked through school, but THEY were the ones who got the merit-based scholarships. (Jason, on the other hand, lucks into everything like he's golden. No experience? Not a problem, have this fabulous job! He says some people are just lucky, but it seems that I am just UNlucky.)

I really hate my life sometimes. More often than sometimes, really. I've had pretty dark thoughts more than once in my life.

To anyone who has actually read this whole thing, thank you, and I'm sorry.
 
Tell them it's BC or a hysterectomy on the house. I hear you on all the problems, mine were awful. Thankfully I'm ok with a normal BC type, it just takes 6 months for the side effects to go away. Never switching again!

When I was a teen, my mom's insurance was through Walmart. The oh-so-helpful customer complaint lady told my mom that they would never cover my medically necessary BC no matter what the docter said (severe bleeding causing bad anemia, unable to attend school during periods), but they do have these nice hormone replacement pills that they do cover... My mom is very mild mannered and I've never seen her that mad before!

It is very strange that the generic version of your stuff causes problems. It's supposed to be the same chemical.:?

Edit: Just read the last bit. I hear you. I had to leave my last job last year due to my fibro, thought the new job would work well and it does, but now the factory is closing and my department is moving an hour away and I'm expected to drive for the job.
 
naturestee wrote:
Tell them it's BC or a hysterectomy on the house. I hear you on all the problems, mine were awful. Thankfully I'm ok with a normal BC type, it just takes 6 months for the side effects to go away. Never switching again!

Yeah, and I leafed through to the "V" section of the drug coverage booklet, it looks like Jason could get Viagra for cheaper than my BC. :grumpy: I might consider trying to find an OBGYN that could write up a hysterectomy as "necessary" for me so it would be covered.


It is very strange that the generic version of your stuff causes problems. It's supposed to be the same chemical.:?

There is actually some leeway in generics vs. brand name. The generic is supposed to be at least 80% the same. Also, "inactive" ingredients aren't required to be the same, so they could use different fillers or binders. So it doesn't have to be identical, just similar. :X

I would assume that after a patent is up, the developing company might lower the cost a bit to try to compete more with generics. But I guess that's why I don't get the good jobs, because I don't understand the reverse-logic in raising the price to better compete with the cheaper competition.
 

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