So, I've been trying for THREE weeks to get one of Baby Grey's medications filled through our health insurance's mail/phone/internet order program, where you can get a three month supply for one copay rather than paying for it each time at the grocery pharmacy.

The thing with this drug (Prevacid) is that it has to be made fresh every 14 days and then thrown out, so I have to pay a co-pay every 14 days for it. So of course I want to do the 90-day supply thing where I can mix it myself every 14 days.

Between the ROTTEN communication at the doctor's office (they have 6 different offices with a million different phone numbers to call and only voice mails that answer any of them with 48-hour call-returns) and the pharmacy's inability to find the correct phone number because of their limiting computer system (only one # pops up per doc's name), I am sitting here three weeks later after 2.5 hours of phone conversations, ungodly amounts of stress, and $75 poorer, and filing a formal complaint still waiting to see if I'll ever get this drug.

Oh, the best was yesterday when I called and they said they finally got the prescription from the doctor's office, but unfortunately there is something wrong with their fax viewing system and the can't view it. That is fucking unacceptable.

I seem to be having a string of bad luck right now. Aside from the raised blood pressure when I have to call the pharmacy or doc's office, I seem to be handling all this shit pretty well.

Damn them!

That is so horrible, LG. I hope your week gets better and that you guys get a decent president who might eventually improve your insanely ridiculous healthcare system. Here prescriptions for children are automatically paid for by the province.

We have a Blue Cross high deductible plan (HDHP) and a health savings account (HSA). It's expensive. Premiums and deductible combined mean we pay about $13,000 per year before the actual insurance kicks in, although we do pay the deductible from pre-tax dollars via the HSA and we do get the benefit of network negotiated rates for services (opposed to what someone without insurance would pay walking in off the street).

There are constantly errors on the part of Blue Cross and doctors' offices, and, because it's a deductible plan, we end up in the middle of billing disputes (i.e., doctor's office submits claim to BCBS, BCBS states what the permissible charge is for network rates, and doctor's office bills us for more anyway, or variations on that theme). Sometimes BCBS "forgets" we're insured with them and they send the doctor's office a note saying we're not part of their network and we get the full bill for out of network rates. Apparently BCBS doesn't realize that they are not supposed to "cancel" coverage on people who are paying around $9,000 in premiums. It's a real headache.

JTC - BCBS is quite possibly the WORSE carrier in the US. Ever. When I worked for GE we dropped them like a bad habit as the provider... it was UGLY.

LG - sorry to hear it. It can be such a nightmare. I was benefits admistrator for a few years ... and what I tell all of my family and loved ones is your are your own advocate...and document EVERYTHING.

My husband's new job keeps screwing up paperwork like only a federal office can, so his start date keeps being pushed farther into August. I have no insurance anymore and have officially run out of my very expensive medications. Ahhhhh!

I'm actually really missing the Army right now.

Lady Grey, that sucks. Nothing is more frustrating than that kind of mess. I have to go around with my pharmacy every now and then because they thought I was a "drug-seeker," despite my valid prescriptions. I look healthy, so I obviously don't need pain meds, right? My big, scary, normally gentle husband set them straight for me after they made me cry. Now there is a certain pharmacy tech who actually runs when she sees me walk into Walgreens.

JTC - you're scaring me. Our new insurance is a BCBS plan, but for federal employees. I use the hell out of insurance.

We have Aetna HMO for the self-insured and thankfully - so far so good. We pay about $7500 a year, plus co-pays and up to $2,000 for any hospital visit.

We're all pretty healthy but I really do think basic medical care should be provided by the Gov't and not by employers.

Why did it ever evolve that employers are responsible for health care?

Because it is a great way to keep workers handcuffed to their shit ass job, and it stifles creative new business development as well as a true free market economy by discouraging entrepreneurs from going it alone specifically due to health care coverage concerns (especially for those with pre-existing conditions).

Actually, the biggest reason it evolved in to this system, sadly, was desegregation. White folks didn't want to have to be treated in the same doctor's office as black people, so private insurance companies arose to legally segregate the masses.

I had my own health insurance until March, and then moved to my husband's. My insurance covered all medications and they moved me during my pregnancy from Nasocort to Rhinocort because it was Cat B. It was AMAZING. I could breathe for the first time in YEARS, I didn't get sinus infections. It was a wonder drug.

Now I'm on hubby's insurance. I go to fill the Rhinocort because a) it WORKS WORKS WORKS and b) it's best for breastfeeding (L2 not L3 like the rest) and they say, "Nope sorry your insurance company feels like you should be on Flonase, and will only pay for Flonase.

It's been 3 weeks on Flonase and it's like I'm spraying water up my nose. I have a constant sinus infection and I can't hear out my ears anymore. But they think it's the "best bet" (read: cheap generic) so that's what I'm forced to use.

I could pay 120 dollars every 3 weeks for the Rhinocort, but ....aww FRAK it.

Bap2, I can totally relate. I had insurance a few years ago (I think while in grad school) that wouldn't pay for Allegra for me once Claritin went generic because it was cheeper for them for me to pay for an OTC 30-day supply or Claritin (which cost over $20 at the time) than to pay my $15 co-pay for the Allegra. Yeah, assholes, except I can't sleep when I take Claritin.

And I hate Flonase. Rhinocort AQ is so much better. Sorry. That sucks.

Does anybody know what the hell "coinsurance" is? I had surgery in April, and I'm responsible for a portion of the bill, apart from my deductible, that isn't covered by MedMutual. I could probably try and find this information on MedMutual's sites, but I'd rather not have to decipher their whacked-out insurance jargon.

Mamawho, I miss the army sometimes, too. The care that we received usually wasn't top-notch, and they told us to go to the ER every time we got sick because the clinics were always booked (of course, this resulted in a packed ER), but it was just so easy to understand!

Stephanie - this is usually how coinsurance works: your insurance pays X% and you pay X% of all bills, usually until you hit your annual out-of-pocket cap. After that, the insurance usually pays all of the bills. Yes, this is over and above your deductible.

I got great care through the military - if the clinics are full, you can request to go off base, but you have to know that you can do that. (My husband used to work in hosp. admin. in the Army) When we moved off base, I ended up in the Scott and White system, which is one of the top hospitals in the country.

Military medical is frustrating sometimes but really only in the small clinics when you ask for referrals. In Great Lakes we went to the core side hospital and everything was there. So I got my referral from the doctor and then went upstairs myself to set up the appointment.

The great thing is once you've had a referral you can just ask for one at your next base. It works in theory but here in rink-a-dink Dahlgren I still have to schedule an appointment after asking for a ref three times.

My husband had some chest pain and the doctor sent him for a stress test or some such thing. I didn't tell him about the $457 bill for it because I was afraid it would give him a heart attack.

Ugh. We had a terrible three-way with my insurance, Ebay's pediatrician, and us for about 8 weeks back in November.

She was prescribed Synagis when she left the hospital, which is the RSV vaccine. It's a once a month shot, given throughout the cold season. The hospital offered to give her the shot the day we left, but we'd have to wait around another hour for the person we needed to give permission to give the shot. We said we'd work on it next week, we just wanted to get her home.

She was discharged late Friday afternoon. First thing Monday, I called the specialty pharmacy's number on the handout the hospital had given us, to arrange for her first shot. No response. After two weeks, i finally got a person to tell me they no longer work with MVP. I immediately called MVP, and found out they'd switched to another pharmacy the month before. Got that pharmacy's number, called to order the prescription. They said MVP hadn't approved the Synagis yet. Called MVP back, they said they'd look into it.

Ebay was discharged on November 30, we got the letter saying she was approved on December 27th. That day I called the pharmacy to arrange shipping the first dose to the doctor, they said they needed the doctor to fill out some forms. Got the doctor on the phone, there's one person who deals with Synagis. She promised me she'd deal dirctly with the insurance and get it done ASAP.

Two weeks later, I called the doctor to see why we didn't yet ahve the medicine, she said the insurance has never responded to her messages. I called MVP, they said the pharmacy still needed the paperwork. Nurse said she faxed it, showed me proof it was faxed 2 weeks ago. She re-faxed it and called MVP.

This is getting tedious, so I'll just tell you that Ebay got her first shot in mid-January, mid-February, and in mid-March I realized she's not going to get all 4 shots she was approved for.

I worked with the pharmacy to arragne for delivery of the 4th shot to the doctor on March 31st (the last day of coverage) and then we stored it at the doctor's fridge until mid-April, so she did get all 4 shots.

But what really bugs me is that when Ebay was MOST vulnerable to get sick with life-threatening RSV, she wasn't getting it because of red tape.

We hit our cash out of pocket limit in February with the kid, and we still manage to get epic bills from everyplace, until we correct some stupid error- transposition of digits, whatever.

Copays are still eating us alive, $25 at a time.