Tuesday, September 16, 2008

Health Insurance, Disability and Prescription Drug Coverage

I had actually planned a more positive post for today, but the advice I  have been given from fellow bloggers is "write from your heart", and today isn't the best day.  I am on Social Security disability due to all of my illnesses.  I have Medicare coverage and Part D coverage as far as prescription drugs go.  Last week I had dropped off two prescriptions to be filled, and when I went back the next day to pick them up, the pharmacist informed me that I had no prescription drug coverage.  

I spent all day that day on the phone with Humana, my part D provider, trying to find out what the problem was.  Long story short, I moved last fall from one state to another.  I notified both Medicare and Humana of the move and my new address.  Evidently, I was supposed to be signed up with a new Humana plan that covers the area I live in now.  I wasn't notified  of this, so I was disenrolled for coverage.  That meant that I had to re-enroll, which wouldn't be effective until Oct. 1, 2008.  I take multiple medications daily, many of which are life sustaining and cannot be stopped without tapering.  I spent the entire day working on getting this resolved, and by the end of the day I had been granted coverage to fill the gap between now and Oct. 1st when the new plan kicks in.  I got my two prescriptions and went on my way, thankful that things had been resolved, but exhausted from dealing with it all day and the stress it entailed.

Last night I called in a refill for a prescription after my pharmacy closed.  I used an automated system so the medication would be available for pick up this morning.  I just got a call from the pharmacy saying that when they tried to fill the prescription, they were informed by Humana that I have a gap in coverage and am not eligible for prescription coverage until Oct. 1st.  I have several doctors appointments this week, where I will get other prescriptions that need to be filled, and I am in tears.

I gave the name and contact information for the representative at Humana who "fixed" things last week to the pharmacy, and they are trying to get it resolved.  If they can't, I will be back on the phone trying to deal with this, while flaring and in pain.  I know this type of thing happens to all of us at some point or another, but it seems particularly daunting when we aren't feeling well.  I only  have a very limited amount of energy today, and frankly I have tasks I have to accomplish besides this.  I get frustrated that in the world we live, with automated phone systems and computers, it is so difficult to reach a human being and just get something resolved.  I am sure that this is some sort of error, probably the information hasn't been entered into the correct system, but why must I spend my precious energy dealing with a problem I didn't create to begin with, and one that I worked over 8 hours last week to settle?!!

Thanks for letting me have my rant and vent.  I know that all of you out there have gone through this type of frustration, whether it be with disability, Medicare, your doctor's office or some other entity.  I feel that there is no other group of people who understand better the physical and emotional toll these types of things take on us, who have enough to deal with in a day without any extra drama.

Today I ask for your prayers (if you pray), or your good thoughts and good wishes if you don't.  I hope this will be able to get resolved with the least amount of trauma possible.  I certainly don't have the financial resources to pay full price for the medications I need and I don't have the time to try to get them from the manufacturer or some other program for free or at a reduced rate.

Be kind!


Jeanne said...


These problems are disgustingly pervasive. I'm so sorry you are going through all this but you are definitely not alone.


Anonymous said...

I'm praying. Been there as well.