I thought the war on drugs was about hard core stuff like heroin and cocaine, but I’m willing to bet either of those would be easier to get than the prescription medications that keep me breathing. For that, insurance companies cooked up a special hell called the “specialty pharmacy.” Mine is CareMark.
CareMark exists in a place where there are lots of phones that no one answers. I think because they are busy recording messages for the phone tree that eventually leads you right back where you started, without ever having a human interaction. This is a problem because I have to order my meds every 30 days, to be sent overnight, or I don’t get them at all. We can’t run down to the local pharmacy and grab an emergency supply. The really good, expensive drugs are in Ft. Knox somewhere and I’m pretty sure only 2 people know how to open the vault.
CareMark’s automated system actually calls me every month to remind me to refill my three prescriptions which of course can only be accomplished by speaking with a real human on their end. So I follow the instructions to speak with such a being, and typically have little luck before I land back in that same ugly phone tree.
The saving grace, I guess, is that CareMark Humans call me on a regular basis. The nurses call to see how I’m feeling (because they care, deeply) and to remind me how important it is that I keep plenty of medication on hand, and never miss a dose. The pharmacists call for the same reason. Apparently the nurses and the pharmacists only speak to patients, and not each other, because they are always shocked to hear that I just got off the phone with someone else on their end. Wherever that mythical place might be.
When the CareMark Humans call me to emphasize the importance of never missing a dose, I say “great, let’s order more now to be sure I don’t run out!” I mean honestly, no one is more interested than me in ensuring I don’t miss a dose. They say they too are interested in that, but in the next breath tell me it’s too early to order another 30 day supply. No one on their end seems to appreciate the irony of this when I point it out.
When I finally, finally get a Human and the timing is right to reorder, I have to answer a series of questions including confirming that I have taken a pregnancy test because apparently these drugs cause horrendous birth defects. I laugh and say “I’m 51, and I have spent my entire adult life not getting pregnant. Never wanted to be responsible for a miniature human. Trust me, I’m really good at not getting pregnant.” And they say nothing. Because they have a box they have to check off. So I sigh and tell them I have taken the pregnancy test. More silence until I also add that it was negative.
And every single time I manage to speak to a CareMark Human, regardless of whether I called them or they called me, I have to run through my DOB and shipping address to prove that I’m really me. As if someone would willingly put themselves through this torture if their life didn’t depend on it.
But there is other Human interaction. CareMark sends a nurse to my house, usually when I start a new med or change the dosage. They take about 15 minutes to listen to my heart and lungs, take my blood pressure, and talk me through the complex process of taking three pills a day. They then spend 45 minutes at my kitchen table writing up notes and asking me endless questions about my medical history. As if that isn’t on file in a million places. Of course the nurse has to run the gauntlet too. First, no coming in through the front door because my cats will try to get out, so he has to come in through the garage and mud room using our patented airlock system. Once inside, there is Janet. Janet looooooves the nurse. She loves all his stuff too, which is why she immediately gets to work licking his stethoscope and rifling through his papers.
Janet and Nurse Kevin
My nurse is a good guy but Janet is a pest. Short of locking her up I can’t keep her away from him and his stuff. So in between trying to work around her and write up his notes, he reminds me repeatedly that he is “more of a dog person.” I believe him.
So there really is a war on drugs, and even pets are getting involved. I have to get back to the front lines.
Ugh! Jumping through all those hoops to get what you need and what you’re paying for is terrible. Some horrific sadist must have dreamed up that system!
It’s really ridiculous because the meds I take are extremely specialized to my disease, no one would be interested in getting them unless they needed them. Ugh!
It is terrible what you are going through to get the medicine you need in order to breathe. I hate to admit that I know all to well this hell you speak of, as I go through the same thing with test strips (as if people would want to poke themselves and bleed), insulin, and other supplies. Medicare loves nothing better than to say no it’s not time yet to refill your med, and don’t get me started on the supplemental health policy. Their job is to say no after Medicare says no. Let’s all stay healthy and annoy the hell out of all of them.
I hate that you have to through this too. I think together you and I are some of the Baddest Babes ever. So they should all know what they’re dealing with when we team up!!
Oh my gosh – what you’re going through is HORRIBLE! It sounds like a Saturday Night Live sketch but unfortunately, it’s true. Best of luck. Bastards!!
Thanks. The whole thing sucks but can’t lose sight of how lucky I am to have good insurance. Otherwise I couldn’t get my paws on the meds at all!
I have one drug that I have to do circles to get. Not like your circles though. You are pretty special and your circles are more like some complicated dance steps that I would never get. On another odd note, my dear deceased cat Jake was diabetic for 8 years. I had to buy diabetic stuff. Lots of it. Some of it was expensive. Since his death I’ve been getting very nice email messages from diabetic supply houses. They say they miss me and would like to have me back. *whacks head on wall* All the prescriptions were clearly marked feline. Jake would be so proud to be missed.
That’s very special, how deeply the diabetic supply houses care. And if you think meds are difficult, imagine the fun I’m having with disability insurance claims. The good times simply never end!
My best friend ended up needing an attorney to manage her disability claims. It was too overwhelming for her and she needed SSI too. Isn’t it odd that when you are at your worst you are put through the biggest hoops.
The insurance companies require you to file for SSI. The whole thing is insane. In my most recent message to the rep I said I’m literally sick and tired. This is a mess. I mean I paid for this insurance!!
I used to fight with insurance companies for a living, so I know of that you speak (doesn’t that sentence make me sound like a non-native English speaker?). They are truly evil. The disability insurance people are just as bad.
One trick they like to play is to stop paying for no sound medical reason. Most people are too ill and tired to fight. Be careful about hiring an attorney, they try to get paid outs for the least amount of time invested. It’s to the disability insurance company’s benefit if you get SSI (it reduces their liability/paid outs) so they will usually supply an attorney.
When we moved, we notified the insurance, they immediately put my husband through some physical testing so horrific the PT administering the testing kept apologizing and was truly concerned about injuring him further. About a month after we moved, we got a letter saying that he was no longer disabled.
I wrote them a letter, containing information such as the definition of the word degenerative, in degenerative disc disease. And I believe I threw in a reference to the California insurance commission. It was 11 years ago, so who knows what the pertinent laws are now, but they got back to paying. Then at 65, my husband was switched over to social security and no longer entitled to payments…
regards,
Theresa
That’s awful! I don’t think I will need a lawyer. Insurance company of course graciously provided a consultant to help with SSI so they can get the offset. And also because they care deeply about my well being.