Wednesday, January 16, 2008

"Let go and let God"

I am now on a quest to "Let go and Let God" in regards to this whole IVF/baby/IF saga; therefore I have decided that I need to get today's newest frustration off my chest so that I can wash my hands of it and "let God"...sooooo, here's my next moan-fest about this money-hungry world that we live in...

A month or so ago, I was at the pharmacy picking up my birth control pills (bcp) for the start of this IVF cycle. I noticed that I had to pay for them, which was contrary to what the Dr's office (benefits coordinator) had told me that my insurance would cover...I was to pay for only the med. co-pays...I spoke with the pharmacist about it and he printed me off the receipts from that prescription and also the one in July, which I also must have unknowingly paid for. I called the ins. company about it and they told me that I would have to get prior authorization on bcp, since usually it is not covered (when being used for traditional birth control purposes). I had the dr office fill out a form for prior authorization, which was then faxed to the insurance company. I figured, in my naivety about insurance companies, that since the same doctor signed the authorization form as prescribed the meds, that they would just go ahead and reimburse me for those two prescriptions...after all, that was why I was going through all this trouble in the first place. About a week later, I receive a paper telling me that my bcp prescription would be covered for a year, starting on December 17th...which was the day the dr. had faxed the form over...

...so, another call to the ins. company...another time explaining my case...and this time, the woman tells me that I will need to fill out a Prescription Reimbursement form for the meds in question. Ok, that makes sense to me...now that the meds have been approved by the insurance, it seems reasonable that I should have to fill out this form, considering that they were purchased prior to the authorization date...so, I go through all the mumbo-jumbo of filling out the form and getting the pharmacist to sign it, yadda-yadda-yadda...

Lo and behold! Today, I get an envelope in the mail from the ins. company and I am feeling like today is my lucky day! A check for $60...nope, no such luck..."We're sorry to inform you that your claim has been denied!"

So...in other words....you approve a prescription for coverage after I already had to purchase it (I mean, I needed it after all) because you never bothered to let me know that it is only covered in special circumstances (which I have) and with special approval (which I also have). But you somehow expect me to know that I must have special approval for those special circumstances IN ADVANCE of knowing that they weren't even covered in the first place...are you still with me? good...me neither...sigh

Letting go and letting God...

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