Friday, August 13, 2010

Dear Anthem, I hate you.

Ya know - sometimes I just feel like all odds are against me. Seriously. It's like every time I have a "good" day, something else comes along and knocks me on my butt.

So imagine this. Yesterday was CD2. I had been up since 6:30am, and on my feet for most of the day... in heels. I was exhausted, mentally and physically.

I headed to Wal*Mart as soon as I got off work. I walked up to the counter in the pharmacy and gave the lady my name and date of birth. She pulls it up in the computer and was like, "Um...Clomid is out of stock.". Great. And then she adds, "and you do know that your insurance isn't covering that?" Um no, actually I didn't know that. They've covered it every other time I've ever gotten it - to my knowledge! I told her that I was just going to have to pay the $80.00 for twenty pills. I had to have them, because I start taking them TODAY. She said that the earliest that they could get them would be Saturday afternoon. That wasn't going to work, so I got the prescription back and headed to Kroger. And to call Anthem.

When I called Anthem, my call was quickly taken by a lady that could barely speak English. Great. I tell her what the deal is, she pulls up my account and within two seconds I got the "Oh your policy doesn't cover fertility drugs." Ok, I get that. But why have you been covering them for the last three months?? Oh, and for four months almost two years ago?? She seriously sat there and argued with me for ten minutes that I had never gotten this medication under my policy. Uh, yes I have. She seriously sat there and told me that I must have used a different policy, because it's never been filled under the one that I currently have with them. Funny thing. I have had this SAME policy since March 2008 when I started working where I work now. Hmmm. After all the arguing, she finally found where I had gotten Clomid under that policy before. Not once did she apologize for arguing with me. As soon as she found that she immediately told me that every time a prescription came through for Clomid it had been rejected. "EVERY SINGLE TIME". Um no, it's hasn't. She told me, "it's been rejected every time since February 2009". Really? That strikes me funny because I started taking Clomid in October of 2008. So they covered it and then just stopped?? Weird.
When I got the last Clomid filled (in June) it was 150mg, and I got it for like $23.00. Ok - so 50mg more a day is going to cost me $80.00??

I got to Kroger, puffy eyed and BLOOD red. When I get mad, I cry. And needless to say - I was furious. I walk up to the drop off window - told the lady what the deal was, offered my insurance information and told her that it probably wouldn't be covered. She looked at the prescription and was like - "uh, let me see if we have any in stock". She went to the back, and when she came out - she told me that they were completely out. Didn't even have enough to get me started for one day. She told me "it's probably back ordered". *sigh* I was ready to seriously throw in the towel at this point.

I then headed to Walgreens, last resort. When I walked back to the pharmacy, the "drop off" window was closed. Again...great. There was a lady at the counter, so I asked her if I could drop off a prescription. She said yes. Good. I told her what the deal was, that nowhere else in town had it - and that my insurance wasn't going to cover anything - but I was prepared to pay for it. She told me "I don't think I have this many, but I might have enough to get you started." Well - she checked and they had 20 pills. Thank you Lord! I was on the phone with Clif relaying everything to him, and she interrupted telling me that their price was $53.99. Thank you Jesus!

It was just ar really stressful evening. If they're not going to cover it, it's fine. But don't be so wishy washy - and don't be a jerk either.

I didn't get home until almost seven and then had to cook dinner. Needless to say, after I ate I layed on the couch - Clif rubbed my back and I was asleep before nine oclock. :)

I am SO looking forward to the weekend away in Tennessee.


Lindsey said...

How rude of the'd think she would at least apologize for arguing with you when you clearly were right! Glad to hear your day got better:)
Fingers crossed for you! ,X,

mommy4boys said...

I am so sorry you are having such a hard time with this. I know talking to some of the people at Anthem can be like hitting your head against a wall. And sometimes they don't know what they are talking about. I know our Anthem plan will only cover a Rx 3 times through a pharmacy and then we have to mail order. Maybe that's the problem. I hope it all gets figured out for you soon.

Trennia said...

I know that must have sucked,but glad you got it finally!

Anonymous said...

Ugh, I swear sometimes we are being tested by God or the universe to see how much crap we can take before we just lose it altogether. <3 I am really glad it worked out in the end for you though.

Lori said...

Bless your heart!!!! I'd have insisted to talk to someone above Ms. Ignorant...that's just ridiculous. I'd also demand to know how it had been covered before because if it was before and they can't come up with a good reason that it isn't now, I'd push it. They'll either have to admit to an error (in which case, I'd tell them you were reporting them to the Insurance Commission in VA because you were under the impression that these would be covered since they previously had been and this error on Anthem's part is causing you distress) or they'd have to figure a way out to cover it after all. Which they do all the time. I get SO angry at insurance they are doing you such a big favor. Ummm....they are paid QUITE well.

Praying you won't need them after this!

croleyc69 said...

Sorry you are having such a hard time. I pray for you & cliff so much. I'm also glad that someone had what you needed and at a lower price.


Hannah Rose said...

Where did you go in Tennessee? I love it there. I went to Bryan College in Dayton, in between Knoxville and Chattanooga. It's just beautiful. I'm sorry you had such a sucky day. ughh those days are the worst

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