Thursday, April 15, 2010

Health Insurance? Oh, we have BCB-Ass.

I don't ask a lot, or expect much, from our health insurance provider. I mean, it's not like we're paying thousands of dollars each year in premiums for coverage that we rarely use. And I understand that expecting them to provide 100% coverage for medically necessary procedures is out of the question because after all, their CEO's, COO's and POS's have to make a living, too. Sometimes it helps me sleep at night if I think of the money we're spending on these premiums as a charitable contribution, except the homeless shelters I'm contributing to happen to be located in Cabo and are used by health insurance executives. Executives that will one day, hopefully, be eaten by sharks.

About five years ago, we discovered that Zach suffered from seasonal allergies. How did we come to this realization, you ask? Well, when the spring grass emerged and cottonwood fluff was blowing through the air, the non-stop sniffling and headaches started, he would rub his nose so hard I thought it was going to end up even flatter than mine and the French's mustard-colored crust gluing his eyes shut every morning were all pretty good indicators. I know, I'm a pretty perceptive person.

We tried to manage his allergies with something over-the-counter, but nothing worked for all of his symptoms. Claritin would help his snot issue, but his eyes still needed to be pried open in the morning. Benadryl helped his eyes, but only because it made him sleep for 23 out of 24 hours. Zyrtec made him groggy, which resulted in him acting like kind of an ass, with an itchy nose. Eventually we ended up getting a prescription for Allegra-D, and have been enjoying snot- and crust-free springs ever since.

A couple days ago, I called our pharmacy to have the prescription refilled and received some less-than-terrific news. Our insurance company was no longer covering Allegra-D, or it's generic equivalent, and was sure that Zach would be fine using something over-the-counter and cheaper for them, like Zyrtec or Claritin. I guess this makes sense to me, because clearly the only reason we have been filling this prescription for four months out of the year is to stick it to the insurance company and get our money's worth after paying our premiums. I mean, how did they find out that once we get the drugs home, we just flush them down the toilet and then watch Zach suffer from excessive snot production and crusty eyes?

Considering the tedious trial-and-error process I went through five years ago in order to find something that worked, it thrills me to know that some asshole at BCBS decided that since we pay bazillions of dollars in premiums and, on average, receive $300 in benefits each year, they should try to make even more money and discontinue coverage for this particular medication. I can see how we are a huge financial burden because, after all, they have to cover two prescriptions for our family: Zach's allergy pills, and that other drug that I take every day in order to prevent creating someone else that might need allergy medication.

I'm sure they'll never discontinue covering my drugs, though, because if they did then they might have to pay for maternity services, which can get kind of expensive. And it's been a few years since I've received benefits for labor and delivery, so I don't even know if they pay for a hospital room anymore. Those assholes at BCB-Ass probably think that I'd be fine giving birth using something else, like a barn floor, without hay. After all, they wouldn't want to make Zach's allergies flare up.


Rebekah C said...

That's just outrageous. We all know how terrifyingly expensive *allergy meds* are. @@

Kellie said...

Try having your physician fax them the records showing that he has tried the other medications without success. They will often (but not always) then pay for the needed medication.


And Rebekah C, if you are being nice, then ok. If you are being facetious, then good grief. If you are paying for your insurance and one of those "benefits" is prescription drug coverage, then cover the damn prescription drug.

The Mean Mom said...

For anyone that reads the blog but isn't on Facebook, you missed a pretty entertaining discussion today, which was triggered by this post:

Anonymous said...

Don't be so sure about that birth control....our insurance wouldn't cover it until a few years ago. Maybe that third kid of ours did the trick? Try taking the Zyrtec at night if you can't get the Allegra. My 10 year old is fine...and I swear it does not make him tired...Go to bed already! Costco sells generic Zyrtec 365 pills for something like $15.00 - makes it worth the membership.