60 x 3 = 180.
Except When You're Counting Pills.

In a previous post I mentioned how baffling the behavior of my health insurance provider continues to be. The saga continues.

I have been trying to get all my regular prescriptions via mail, so that I do not have to go to the pharmacy each month to pick them up. Since I am on 8 prescriptions and their delivery dates cannot be synchronized, in practice that means a couple trips to the pharmacy every week.

Getting three-months supplies of each drug by mail would be a great convenience for me and—I thought—a money-saver for the prescription provider, since the mail order provider, working in bulk, takes a smaller cut than the behind-the-counter pharmacist.

But when I submitted one of my prescriptions to be filled by mail, the mail order drug people told me my insurer had refused to approve payment for it. The drug was too expensive. Now, I have been taking this drug for over a year, and the insurance company has never balked at refilling the monthly prescription. The price of 180 pills to cover three months cannot be higher than the cost of 60 pills to cover one month. If there is any difference, the bulk purchase should be cheaper—the saving on time and packaging alone should cut off a couple bucks.

I pointed out to the nice person at the mail-order pharmacy’s customer service desk that the cost would not, in fact, be higher. I think she may have even agreed with me, but said I had to take it up with my insurer. I did. They told me to call the prescription benefits company. I did, and once again I think the nice person on the phone agreed that 60 pills over 30 days three times would cost no more than 180 pills over 90 days. All the same, she said my physician would have to contact them. I pointed out that he had written the three-month prescription in the first place, so clearly he thought that there was a good reason for it. Logic did not prevail here either.

So what it comes down to is that I wasted my time trying to do something that should be simple. The three companies that together delay my prescriptions saved not a cent and squandered at least some on the salaries of customer service representatives that they do not allow to serve customers. And my physician spent time he could have used to talk to patients or read medical journals pleading with a benefits company to provide a drug it had already approved for me in the amounts I was already receiving. To whom does this procedure make sense?

I am again led to suspect that the companies who are supposed to pay for medical benefits make things complicated simply in the hope that patients will give up, say the hell with whatever prescription or treatment it may be, and try to get along without it, no matter what effect that has on their health. If they are paid by the number of patients enrolled, that will put more money in their pockets until some frustrated client actually dies—and that, I suppose, is just a cost of doing business.

Again, I don’t see how the new Health Care System is going to address this problem.

I have just had three tests—the last two preceded by calls from the insurance company about cost-cutting—and I see a specialist on Friday. I dread the billing more than any actual procedure he may recommend.