Why So Complicated?

Mods, Please feel free to move. I'm not sure if this belongs here or Rants.


It all started when my wife changed jobs, along with insurance companies.
My wife is an RN and for reasons we won't go into now, went to work at another hospital. While we had the previous insurance, I could just go to my doctor's office, get my prescriptions and have them filled. No problems, right?
Well, now that has changed. I take Humira for rheumatoid arthritis. Now, because of the insurance, it has to be shipped to me by "Special Services". Basically UPS with a cold pack to keep the medicine cool. The maddening part is: I use the same pharmacy as before. They keep it in stock, so that can't be the reason. It's not a narcotic of any sort, so it rules that out.

It's been a 2 week run around to get this filled, so, now I'm 2 weeks behind on my med. I called the special services hotline to find out what the problem was. Answer? My doctor's office had faxed it to the wrong number. Wait for it... It was the pharmacy number. You're not supposed to fax it to them. Huh? Never got an answer to that. To me this is a perfect example of why health care is so expensive. Uselessly, hopelessly complicated red tape, when it could be made so much simpler. Why does an insurance company have a whole division dedicated to this?
The medicine use to cost about $120 a month with the previous insurance.
Now, it's $210 a month and much harder to process the prescription. So, what's all that extra for?
I've been going over and over this in my head and keep coming up with the same question, Why So Complicated?

Explanation: S&F!

Personal Disclosure: Sorry, I have no clues!

Bumped because this thread needs an answer!

Although I could be wrong, it appears that this second insurance company is more greedy and crooked than the first one. They want to cut out the middle man (the pharmacy) and use a wholesaler to ship it to you.

They charge you a bunch extra while they pay less because there is no pharmacy with overhead involved.

Basically, your new insurance company is more of a rip-off than the last one, they are making more money off of you while your service is much poorer, and they are laughing all the way to the bank (and banks, BTW, own the majority stock of most insurance companies).

Don't know if this clarifies it or not. I also have RA, but I refuse those types of meds, as the side effects in the end are worse than the disease. I use vitamins, herbs, and have cleaned up my diet. But everybody has to deal with it in their own way, so best of luck to you.

reply to post by FissionSurplus



Maybe they cut a deal with the makers of Humira. Funny thing is, all other parts of the insurance are far better than the previous company. It's just when it comes to these type of drugs. They are classified differently, so have to be processed differently.