The Quagmire

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The Quagmire describes my mind -- full of random bits of things all stuck together -- these things may include, but are not limited to: music, TV, movies, writing, reading, theatre, politics, religion, whatever.

Thursday, April 05, 2007

Aetna Blows More than Monica Lewinsky

I fucking HATE insurance companies. Today, I think I shall rip Aetna a new asshole in my blog because they so richly deserve it. They probably have plenty ripped assholes already, so one more ought not bother them. Aetna is comprised of incompetent, idiotic assholes. I think they hope I die before they call back so they don't have to pay anything.
I have an Open Access POS plan through Aetna. No big deal. It's basically an HMO with an open access option (for which I pay extra). It means you don't need a referral to see a specialist. You pay a double co-pay, so you don't save any money. What you do save is time because you don't have to go see your primary, pay a co-pay, and then go see the specialist.

I'm an adult. I know what part of me is broken, so I if I need an otolaryngologist (ear, nose, throat) because my throat is having troubles, I can go. I pay a double co-pay because he's a specialist, hence I've not saved any money, but I have saved at least a week in time, which is priceless.

They insist I'm on an HMO even though I'm on a POS. The billing computer has it right, my card is right, but the service-provider's computer (where they check if your coverage is active) doesn't. So when my doctor calls, it tells them I am on the basic HMO plan. So my doctors all want referrals even though I don't need one. If I don't have a referral, I am not covered. That might not sound so bad except when you don't have a referral the insurance doesn't cover the visit and you're looking at $400 instead of $30.

This bit has been ongoing. I have spoken to people at Aetna (as well as my independent insurance agent) all of whom have promised to call me back. Some have asked for faxes, for details, and my contact information. Aetna is comprised of incompetent, idiotic assholes. Like I said before, I think they hope I die before they call back so they don't have to pay anything.

The people I've spoken with all assure me their computer shows I am covered. However, from what the doctors say, I am not covered. One of my doctors even had the information faxed over to me which quite clearly shows I am not covered. I have faxed this to them, my agent, anyone who wants to see it. It matters not to them. I am a human and Aetna cares not one iota for humanity. If I were a dollar bill they would be fawning over me like a lecher over a sixteen-year-old cheer leader.

But wait, there's more!

But that's not all. So I'm on these drugs that the otolaryngologist prescribed and I have two days left. Last time I checked my doctor is a licensed professional. The drug (if you care) is Nexium 40 which is to treat my severe acid reflux, the cause still being under investigation. I am supposed to take two per day which is 60 per month. First time I went to get them, Aetna gave me a hard time and said this drug needed pre-certification. I couldn't get them and had to call the doctor's office who had to argue with Aetna. The prescription was issued and the label clearly says "take twice per day" -- okay, boys and girls how many pills is that per month? If you got "60" you win. If you got "30" you work for Aetna. So after two weeks with 30 pills, it's time to renew. I always renew online because it's easy. I go to pick them up. Apparently Aetna feels they know better than my doctor.

So the pharmacist at Walgreens – a very nice man – let me use his phone so I could call Aetna. I went through dozens of voice-activated automated menus. Everyone around me laughed because none of the menu prompts would recognize my group ID. After much aggravation, I finally got to the part where you say “operator” to get a human and I said "operator." It hung up on me with no explanation. I started about 4:55pm and got hung up on a little after 5pm. When I called back and went through the same hell again, it said, I had to call back between 8am and 5pm (what happened to 24 hour service for medical issues)? The pharmacist, being the masochist he is, thought he'd give it a try. That failed spectacularly as I found when I called him an hour later.

My pills will run out Saturday. Of course, I can buy them at $188.90 per bottle of 30 and I need two of them. What do you think the chances Aetna will pay are? I've had a number of insurance plans, but Aetna is near the bottom -- only inHumana was worse.

The worst part is, stress greatly aggravates my acid reflux condition. So Aetna's behaviour is actually harming me. I'm sure that's ironic or something. I wonder if I can sue them for attempted murder?

On Tueday, I will file a complaint with the State of Florida Insurance Commissioner. It won't do much good because I have little faith in that office based on what I see of our entire insurance crisis in the state, but if it makes Aetna suffer a little, it'll make me happy.

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Tuesday, October 11, 2005

More Bad Customer Service (Today: Walgreens)

So, last weekend I use the Internet to renew two Walgreens prescriptions. This should be easy. Normally I use the phone auto-dial system out of privacy concerns, but I decided to be daring. I really don't care if you all know I take AcipHex. Yes, good ole' acid-reflux. So much for privacy, eh? :)

Anyway, so I show up to pick it up last Tuesday. The second prescription was ready, but the AcipHex wasn't despite the fact they had three days to prepare it. I ask why it wasn't ready and they said the insurance company wouldn't release it early. I explained that this was a 'vacation refill' (something where you get your prescription early if you will be out of town when it normally comes due). She said that their records didn't indicate that. Now, I don't have a problem with Walgreens on that aspect at all.

What pissed me off? Well they didn't call me to tell me there was a problem. They wait until I show up after 5pm to let me know there's a problem -- when the insurance company is, obviously, closed. I ask what can be done and they said "Well you can pay for it." I asked how much and I was told $196! I said "no" and let them know I'd pick up BOTH of them on the 11th (today) and asked her to note that on the already filled first prescription. I let them know how irritated I was they didn't call me. "Well we don't have your phone number" I was told. I asked for the manager of the pharmacy and pointed at the label of the first prescription, which, of course, had my phone number on it (required by law in Florida).

I show up today to pick up both prescriptions. Guess what? They had cancelled my first prescription because I didn't collect it on time. I must say the pharmacist on duty was apologetic and filled it just under 5 minutes. But can you believe the idiocy?

Then the cashier rang it up at the FULL price. She had to get the store manager to void the transaction and have the pharmacist re-issue the AcipHex at the insurance co-pay rate. Why? The first pharmacist issued the AcipHex before the 11th despite our conversation. Moron.


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