Managed Health Care Sucks

Posted: April 5, 2012 by sneakerporndiaries in Uncategorized

I’d love to have a conversation over a cup of coffee with Sarah Palin about managed health care. I’m so mad!

Every week my HSA contribution, medical, dental, vision, and long term disability items are deducted from my check. It comes to be a little over $75.00, roughly $3,900.00 per year. My health insurance is a PPO with a high deductible of $2,000.00. Once that deductible is met, then the insurance will pick up the tab. Seeing as how my health is pretty good right now, and barring any unforeseen circumstance (i.e. black plague, hurricane in Detroit) I doubt I’ll be meeting the deductible. My therapist put it like this: I get to shell out $75.00 a week to basically not have insurance coverage.

Outstanding.

Our insurance plan runs on a fiscal year. May 1st through April 30th (you can see where this is going). I met my deductible last year when I had my surgery. I have a few weeks to squeeze in whatever I can before I have to pay out of pocket. This includes the stuff going on with my knees. I’ve had problems with my knees for years. And for the past three years have seen someone for them. I’m trying to be a bit proactive right now, hence the cortisone injections this week (and possible Suparts injections in the weeks/months to come). My ortho also prescribed Celebrex (now before all of you post ops freak out, he and I talked at length about this. Short term, I shouldn’t have any GI problems. And my desire to be pain free overrides the possible side effects.). He sent me home with some samples because my insurance company requires a pre-authorization to fill the prescription.

Seriously. Really?

The pharmacist was drilling me on what was it prescribed for, has anything else been prescribed for the problem, what were those items. After the interrogation I was informed they’d have to call the doctor, who has to call the insurance company, who gets to decide whether or not I am to be permitted to have the Celebrex – which will hep with the knees until the cortisone wears off and I seek out Suparts. Side note: the last cortisone injection I had was in November, just the right knee. That didn’t last long.

I was totally annoyed. So I asked the pharmacist what the prescription would cost if I paid cash. $175.00. For a month. True story. I looked the pharmacy tech and said, “Let me get this straight. I can be prescribed Vicodin like it’s candy…but not Celebrex?” She said, “Yep.”

Bull. Crap.

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