I am practicing to keep myself in a state of zen, but as with most things in life there always is something that goes wrong, right?
My RE ordered up the meds for myself and the donor earlier this week. My meds, no problem. The donor’s… should have been no problem.
BUT take the climate we are in economically… where you know damn well everyone is all about keeping their money safe and sound… and guess the fallout and trickle down effect on you and me??
So, the specialty pharmacy gets the donor’s order and sees that it is for an egg donor so the first thing they do is test my coverage to see if it works. It does.
Then, they call me and (BECAUSE the REST of the free world is f’d up), they say OUR NEW POLICY is we need a LETTER from my employer or the medical insurance provider to CONFIRM COVERAGE I obviously HAVE!
It must be on letterhead and include all my personal info and a drop of blood. Ok, I made up the blood part.
THEN, this pharmacy tries to strong-arm me to PAY them $3,800 for meds in cash telling me it’s easier for me to pay now and reimburse later.
Duh, all because they are risk-averse. Give me a break. That ain’t gonna happen.
You can imagine my disgust. And you can also image that it’s impossible to procure such a document from an insurance company that has Stepford Customer Service Representatives working for it. Even hard to get from my employer, which I should remind you is crazy huge and filled with red tape.
Trust me, I spent a collective 8 hours already talking to about 20 people.
So I tell my RE “STOP the Insanity!” for goodness sakes, shop the script elsewhere, and don’t call me until you find a specialty pharmacy that is more concerned about the patient rather than “CYA” and money.
So it’s not resolved yet. I have a monster of a Lupron headache, and I am half thinking I should have continued the acupuncture for stress relief.
Update: Starting to flip my lid… Two other pharmacies, one won’t touch it, the other same story. Apparently a specialty pharmacy uprising has begun on DE policies, I guess.
What the hell? Am I the first person with insurance to order donor meds?? This is looking more bleak by the nanosecond.
12 thoughts on “Who me? Stressed?”
That sucks. I'm just starting my battle with our speciality pharmacy. I've been putting it off but in a few weeks I'll have to deal with it. Spec. pharmacy says we have a $5000 lifetime cap but the insurance company says everything is covered…ugh!!! Good luck!
What an ordeal! SO sorry for the hassle you're going through.
When I did a DE cycle last year, I was curious as to how the clinic would handle the meds order. My clinic placed the order themselves, my insurance covered the meds for me, and I paid out of pocket for the donor's meds. I would be surprised if any insurance company would knowingly cover the meds for your donor to use and I suspect that's what the pharmacies are discovering.
Wow, your update is unbelievable. Like another poster I used Freedom and had no troubles whatsoever. I also used IVP…but that was back in Oct. Maybe things have changed?Any luck contacting your Insurance Co?
I use Village Pharmacy- they are out of RI and MA and they ship anywhere in the US. Maybe they can help? They have been wonderful and have 24 hour customer service.
Did you try Freedom Fertility Pharmacy? On the East Coast and they had the best pricing. They were awesome for me.http://www.freedomdrug.com/Interesting to see this happening. When I went for all my b/w in first trimester (which was every week) they made me given them my CC info even though I was totally covered and had met my deductible. I gave it to them the first time, then one of the lab techs told me I didn't have to. There is a disturbing trend of 'get the money up front' that I'm seeing in a lot of businesses. It's like they see something coming that we don't know about yet. Although I think I have an idea as to what that is.Really sorry you have to deal with this BS and I hope you get it resolved soon.
UHG! How insanely frustrating! I can't believe they're jerking you around so much. I hope it all get resolved soon!Good luck and lots of hugs!
Gosh, I hope the RE can help you out.This is ridiculous, and I agree with Peeveme, your employers should NOT have to be involved.Wow.I hope it is all resolved soon.
I'd try another pharm. Man would I blow my top at that! F*ck them!. And why would I want my employer to know everything about my medical situation. Seems like a violation of the law becasue your employer should not know anything about your medical care…which they would know about if you had to get a letter saying you had coverage for Donors. I hope your RE can step in here.
dude. that is insane!!! hope it gets resolved- and soon!
…and I thought I've had problems getting coverage at our local hospitals for diagnostic treatment! So sorry the pharmacy is jerking you like this:-( It is obvious that these people have not struggled with IF.
WTF? That's such BS. Ugh. This shouldn't be YOUR problem. Blah.