Thursday, September 26, 2013

The way our country is headed...

So today at work, I had to tell one of our patients that the medication that she's been on for 10 years is no longer covered via her "government-funded insurance" company. Earlier this week, her pharmacy called to notify me that her insurance company had denied her refill request.  I contacted the company to see the problem and was told that the patients doctor would need to submit proof that a "less expensive" medication couldn't be used.
 
So after consulting with the doctor, I submitted documentation and the patients records over the last 10 years showing that different medications have been tried with poor results and that a dramatic improvement was seen when the patient started on this, more expensive, medication.
 
But it didn't matter that this medication has worked for her all this time... It didn't matter that I provided the company with PROOF and a SIGNED statement from her DOCTOR. All that mattered is that the medication is expensive and someone with NO medical degree just decided she no longer needs it. Again, the claim was denied and this insurance company refused to cover this prescription. Can you tell how upset I am???
 
It makes me feel awfully uneasy to know that our health is in the hands of people with no medical background or expertise. It makes me uneasy to wonder if I'll start being denied from medications prescribed to me by my doctors...

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