YuleTis the time for holiday music, watching neighbors fall off their roofs putting up lights, making cookies, and spending your nights shopping online.  Well, at least, that’s my indication it’s almost December!  I’m looking forward to the holiday season this year because it’s been particularly stressful with school and work.  Listen to me complain; I brought it on myself!!

I’ve been spending my past month going back and forth with my insurance company to get my prescription for Prilosec filled.  It has been an utter nightmare.  I need a proton pump inhibitor (PPI) for my stomach acid problems.  I’ve been on them all; Prevacid, Protonix, Nexium, Prilosec, etc.  Well, Anthem, my newest insurance provider, allowed me to get Omeprazole, the generic for Prilosec.  Overjoyed, I got my doctor to submit a prescription for 2 pills a day because my problem is particularly fun.  Anthem, being the best insurance company around [sarcasm], asked for a Prior Authorization to be completed by the doctor.  This is their way of making sure the doctor really meant to fill out the prescription the way he did.  Insurance companies know better than doctors, remember this fact.

So anyway, I ended up getting the first prescription approved and got my 180 pills for three months.  I went to go refill the prescription and low and behold now the insurance company doesn’t want to fill it.  Long and short, I’ve been told I have to use Protonix which is a brand name medication and much more expensive.  I’m fighting out with them right now for a prior authorization on that too because of the quantity limitations on Protonix.

My good friend Kelli at my doctor’s office has been helping me from their end on this.  She called me today and hooked me up with two months of free samples of Protonix.  Hopefully by then the stupid insurance company grows a brain.  What a mess.

How is someone with mental problems/slowness/etc supposed to manage themselves when dealing with things like this?  I’ve been bounced between my doctor’s office, the mail order pharmacy, and the insurance company a lot with no single point of contact.  It’s frustrating and stupid.  I’m reading more and more about stomach medications like Protonix coming off of covered medication lists on insurance plans which scares me.  Until affordable generics over the counter become available, this is going to suck.  Prilosec OTC would cost me $40/month or more even by going to a discount chain and buying in bulk.  I was getting Prilosec generic for $10/month.  Which one makes more sense to you??

Categories: Headaches

Artin

I'm a 20-something full time geek, part time student and photographer with a life partner, dog, house, and the two cars. I also have an ice pick in my left temple every day.

2 Comments

ErinM · November 29, 2007 at 5:51 PM

“Prilosec OTC would cost me $40/month or more even by going to a discount chain and buying in bulk.”

That, and I’m convinced the OTC stuff doens’t work as well.

Good luck chasing down the insurance company!

Artin · December 6, 2007 at 10:02 AM

I agree. The over the counter stuff sucks and I can’t see wasting all that packaging (cardboard & plastic) when I could just get the generic for $10. I did get the Protonix finally in the mail though – yay!

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