I hate United Health Care

[poseidon]

This Christmas Eve is apparently not starting off very well.

This morning I might have broken my foot (although one of Michelle's bosses just told me that I likely just bruised the tendon, but he didn't xray it).

Got another notice in the mail today that United Health Care is turning down yet another bill that Michelle incurred while she was in the hospital for treating her blood clots.

Went to WalGreen's today because I'm out of Prevocol. Called the doctor, and he said no problem and called in the script refill (Lipitor was giving me too many side effects). I go across the street to WalGreens and they said United Healthscare denied the script because I'm taking too much of it.

I've been on it a month. This is supposed to be one of those things that you take for likely the rest of your life, and I'm also on the lowest dosage (10mg).

I get on the phone and call United. They say that I'm taking too much of it, and that I'm not supposed to have my script refilled yet, according to their records. According to my records, I'm out of pills after tonight's dosage. I take them once a day at 7pm when Michelle takes her Cumadin, that way we can both make sure that we both take our pills every day at the same time every day.

It was 29 days ago when I had my first pill. I got a 30 day supply. Yet, United Healthscare says differently.

So, I pay out of my pocket $95.83 for another thirty day supply, because I'm not interested in having my cholesterol levels spike because of United's inability to do their job. We'll merely add that into the about $12,000 that we're in the hole for this year because of things that United has decided isn't covered.

I feel like calling the mental health benefits line over there and asking them how to file a claim because they're driving me nuts.

[eris esoteric]

This is why insurance disturbs me. Your doctor says you need something, and regardless of how good your doctor is, you've probably actually *met* your doctor. And yet, the insurance company gets to say whether or not you should take medicine that your doctor says you should take.

And that's the best case scenario, where they don't screw up what days you got your meds last.

Jeff... if you're having trouble convincing the insurance people of when you last got your meds, wouldn't you be able to show them the paperwork from the pharmacy? At the very least, the bottle should say what date the script was filled.

Seriously, though... I hope things look up.

[mjfrombuffalo[$]]

You can always fill the Rx with your own money and then argue it with them (faxing them receipts of course) later.

[erik_kosberg]

Or you could come out in favor of single-payer healthcare. :whenpigsf

Maybe even get involved in the Hillary for President campaign.

[thinkerlady[$]]

have you tried red wine Jeff? It is said to be good for chlorestrol.

[theworm[$]]

Didn't you say that you get your meds as samples from the Dr and don't generally pay for them.

[mjfrombuffalo[$]]

Y'all are being mean to Jeff at his time of need. Meanies. At least none of you reminded him that he has health insurance when so many people in our country have to fight for... oh yeah. Oops.

[frazzledspice]

Insurance can really be a pain, but I found we had less trouble with prescriptions with United Healthcare than we currently do with Blue Cross.

When we had United Healthcare, we paid one of three copays for a 30 day supply. Now, with Blue Cross, we have to pay the same copay for a 15 day supply, unless we get a 90 day supply by mail order, in which case we pay the copay times 2.

But, in more convoluted logic from Blue Cross, I got a receipt for some minor surgery (for which we paid the $20 copay.) The doctor billed Blue Cross almost $1200. Blue Cross said their agreement allowed them to pay $550. The doctor would get paid $550. and we were still only responsible for the $20.

What I can't figure out is how doctors figure a person with NO insurance should be responsible for the entire $1200. when a multi-billion dollar company only has to be responsible for $550.

I think that people without insurance should go up to their doctors' business managers and say, "Listen, you know and I know that a person in an HMO receives this same service for 50% of what you're charging me. You also know that I don't have insurance, which means that I am probably 100% less able to pay this bill than someone who has it. This might eventually go to a collection agency if I continue to be unable to pay it, in which case you would only get 50% of the bill anyway. So why not show some Christmas spirit and Christian charity, and charge me what you charge the insurance companies? Let's negotiate."

It might work. It certainly SHOULD work.

I'm sorry you've had such a difficult year with health problems.

[mjfrombuffalo[$]]

Jeff, how did things turn out?

[poseidon]

As they turned out, United has now changed its mind from, "You're using too much of it" to "We don't want you using that, so, instead, use Zocor."

And, the intelligence behind forcing me to use that instead of the Prevocal is mind-blowing. The Prevocal costs $98/month. The Zocor costs $140/month.

The difference for me? The Prevocal has a $10 co-pay. The Zocor has a $30 co-pay. But, either way, it costs United more to have me on Zocor than Prevocal.

To answer a question from earlier, I do get physician samples for free. Unfortunately, my physician doesn't have samples of Prevocal or Zocor. She had samples of Lipitor that she was willing to give me all that I needed. Unfortunately, the side-effects weren't fun.

[lynnzop[$]]

I've been dying to ask...did you break your foot with the stocking holder?

Ouch. Hope you are somewhat recovered by now.

[poseidon]

The foot was painful for about three days, then subsided. All I have left is a very nasty bruise on my big toe and on top of my foot.