Insurance

First of all, I'm very thankful that we have health insurance. Even though our policy has gotten more expensive and we now are going to be paying a deductible we are very thankful that we don't have medical costs to worry about.

BUT......It is very annoying and disappointing when the insurance company has the ultimate control of what gets approved for the patient.

Case in point: About three treatments ago I was still having issues with a bit of nausea; having to take Phenagran, that would just put me out. So... I asked my Doctor if I could take the Zofran from more days to hopefully avoid the "yuks". He told me I could take Zofran every day if I wanted to. YES, I thought. I went to the pharmacy and dropped off the prescription. By the time I got home, I had a message from Rite Aid that said that the insurance company would not approve the prescription because it was too soon since the last refill, but I could have it on Dec. 21st. Well, that was 3 days later than I needed it. I had a few tablets left that were going to get me through the first three days, but due to the insurance denial I was not going to be able to do add any extra days. So I just did the best I could.

The next time I went to the Doctor I was telling him about it and he told me to take Decadron on a specific schedule for the days I was concerned about, since getting the Zofran was an issue. So again I headed to Rite Aid and the pharmacist told me that there shouldn't be any issues with getting the Decadron. I asked her what the issue is with Zofran and she said that it is an expensive medication and insurance companies will only authorize so much in a specific time frame. She said, "Here you have patients that are going through things as you are and you have to also deal with the repercussions of the insurance companies. She told me that I could go back to my Doctor and have him fax an exception to the company but she also said that there is no guarantee that it would work.

So I came home with my Decadron and took it as prescribed and it actually worked great. So in the end all worked out well, except that the insurance companies have the ultimate say about a patients health and NOT the physician. Isn't there something wrong with this picture?????? What's going to happen in Washington?