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Fun medical billing story: I'm on a couple long-term meds -- anti-depressant and a blood pressure med --that I get 90 day scripts for. Starting this year, my local pharmacy was for some reason only able to fill 30 days at a time, which was weird (1/x)
Then, my insurance told them two things: A) that they would not cover any more 30 day prescriptions and B) that they would also not cover 90 day scripts at that pharmacy. They then simultaneously sent me a bizarre letter saying "it's time to make a choice"
Long story short, my insurer abruptly changed its rules so that 90 day scripts would only be filled at a CVS or via mail order. The closest CVS to me is an hour away.
The chipper insurance rep I reached on the phone framed this as a wonderful choice they gave me, empowering me to take control of my coverage. Never mind that the "choice" boiled down to how to deal with getting booted out of the pharmacy I've been using for years.
So now, I've spent half the morning figuring this out, and it will likely take another couple hours of phone calls to get my prescriptions transferred over to their mail order program. Plus I'll still be dealing with my local pharmacy for incidental scripts when kids get sick.
The "choice" my insurer has so graciously provided means that I'm dealing with hours of additional work, plus a doubling of the amount of pharma bureaucracy my family has to deal with.
"Choice" is so often held up as a virtue of our current private health care coverage system, but in practice what it often means is more work offloaded to patients so insurers can keep costs low. (My insurer, Aetna, was reporting quarterly profits of around $1 billion last year.)
Why is this happening? Aetna merged with CVS last year, which executives promised would lead to coverage that was “easier to use, less expensive and puts people at the center of their care.” As a patient, my experience so far has been the exact opposite.
