Wednesday, March 11, 2009

TOTs (on Wednesday)

I know its Wednesday, but yesterday on Tuesday, I had nothing about which to complain. I thought I'd skip the weekly installment of Ticked Off Tuesdays. But this evening, something so ludicrous happened that I had to write about it to keep my head from exploding.

There is a medication I've been taking for about 13 years now. Every six months or so I have bloodwork done to determine the appropriate dosage. When I went to the doctor this week, my levels were a little high, so she wanted to change the dose. She faxed the "new" prescription to the pharmacy.

This evening when I went to pick up the medicine, I noticed that it was the generic brand. I mentioned to the pharmacist, "I'm supposed to have the name brand, not generic on this." He checked his records and informed me that the prescription specified "No Generic Substitution".....*long pause, puzzled look, deep breath* ....to which I said, "Exactly, you've given me the generic substitution." He said, "I can give you the name brand, but your insurance won't pay for it because the doctor didn't word the prescription correctly."

Can you understand my frustration? Its not really a new prescription,
just a change in the dosage...
Of the same medication...
That I've been taking...
For thirteen years!

The doctor specified "no generic substitution", yet that evidently is not specific enough for the insurance company. So what, may I ask, does the doctor need to say instead of "no generic substitution"? Are you ready for the response? "Brand Name Required" Are you freakin' kidding me?!

What in Merriam Webster's name is the difference between "no generic substitution" and "brand name required"? If you can't substitute with the generic formula, wouldn't that imply you must use the name brand? Isn't that the same thing as a requirement?

Now I do want to go on record saying that I was very nice to the pharmacist. I was patient and told him not to worry, I would call the doctor tomorrow to get it all straightened out. I did not create a scene and say something like, "I'm leaving on a MISSION TRIP in a few days! I'm going to share JESUS with ORPHANS in PERU and I don't have time to argue symantics!" Because you know how much I hate it when Christians behave badly in public... I kept my "composure" in the store, but I was already "composing" my blog inside my head by the time I made it to the car.

And this, my friends, is a perfect example of why I created "Ticked Off Tuesdays".

7 comments:

Jill said...

Pharmacy rules make me crazy sometimes. I went through the same thing when my daughter had the flu and an infection. The doctor didn't word it right so they were not going to cover the 200.00 meds. It took a whole day before they could get if fixed. UGGG meanwhile my daughter was at home with a 104 fever. ugggggg! I feel your pain!

knit1kids4 said...

Oh that is frustrating!

Karen (KayKay) said...

That is crazy and frustrating. I bet it's an insurance rule.

Jerilyn said...

:D Oh it had to be the drug store that starts with a "W" and has the same color in it as our town. (dont want to ruin their reputation)...I went through nearly the same thing yesterday..except my insurance would not pay for it cuz.."Well this is two computers talking to each other and they just wont let you have it right now" said the pharmacy...."whatever" said me..(over the phone) so needless to say $84.00 later..I paid for it myself...pain in my chest but a smile on my face :)

Sturgmom said...

That's one of the most asinine things I've ever heard. Gotta love insurance and their "rules."

Cheryl Hyatt said...

Don't you just love it when insurance companies think they know more than the doctor who has been treating you for years!! I feel for the people (pharmacists) who have to relay the message the insurance companies give them for reasons!

Michelle B. said...

Oh girl, I have so had that happen!!! And we have the same doctor! I am proud of you for not acting out, but quietly composing your blog in your head.I am really trying to do that too; only I usually just get frustrated in my head and don't act out! LOL