Doctor to Pharmacy: “This patient need this medication.”
Pharmacy to Insurance: “This patient needs this medication.”
Insurance to Pharmacy: “Do they though?”
Pharmacy to Doctor: “Insurance wants to know if they really need this medication.”
Doctor to Pharmacy: “Did I stutter?”
Pharmacy to Insurance: “Yes.”
Insurance to Pharmacy: “Fine, Whatever.”
Pharmacy to Patient: “Your medication is ready.”
Why the fuck does this process exist? I’ve never EVER had a doctor change their mind and go “OK, they don’t really need it.” And I take a shit ton of medications. It’s just a way for insurance to stall paying what they’re supposed to pay. I’m so mad!
We’re currently in pre-lawsuit with insurance about an accident I had in 2019 (yes, thats 2 years ago) because they don’t want to pay what they SAID THEY WOULD PAY. We’re not even to the lawsuit part yet because insurance is dragging every single step out as long as possible. And now I’m stuck in this prior medical authorization needed loop with the pharmacy over a medication.
Isn’t the whole doctors prescription thing ITSELF the prior authorization? Like not everyone can or should take these medications so you need a prescription. It’s the fucking authorization. I could see if, maybe, a nurse practitioner wrote the prescription and you want a more authoritative position — but not the doctor themselves. It’s so stupid!
Since the aforementioned accident, I’ve suffered from headaches pretty badly. Physical therapy helped a ton and I’m also on a migraine shot once a month (which also required prior authorization when it was prescribed — oh and would have cost me 1k out of pocket but $5 for insurance — but thats ANOTHER post all together). This shot works great — but not for the whole month. Towards the end of the month I start getting daily headaches again as the shot wears off. This leads to me taking a shit ton of Excedrin Migraine.
Well, apparently thats really bad for your kidneys. So my NEUROLOGIST prescribed another medication I can take as needed or every other day towards the end of the month. It’s apparently the same medication thats in the shot and I can use the pills as a booster. He says he sees patients with my problem all the time. The shots great but it doesn’t last. So this way you can boost it and get through to the next shot. This medication has next to no side effects (maybe some nausea — but by the time you need the pill, you’re probably already nauseous). Where as over-the-counter pain killers will eventually kill off my kidneys.
Well he prescribed it a week ago! I got back to his office the NEXT DAY when I was told it needed prior authorization and I still don’t have the damn pills. My head is killing me! Why is insurance such a fucking scam? I hate it. This prior authorization process requires no less than SEVEN calls that don’t involve me at all. It’s just a lot of bureaucracy to postpone or try to avoid paying.
I’m going to go slam my Dammit doll on the counter while I toss back some Excedrin Migraine.