Ok, so I just need to vent about my call to Aetna today regarding a prescription drug reimbursement. I should preface this by saying that I am not a person who gets sick very often. I deal with insurance companies about once or twice a year, if that, generally when I'm making changes to my plan. My experience today is very minor in the grand scheme. However, that's kind of the point... if I'm this frustrated over my $150 claim, I can't imaging how bad it is for people who have real health issues.
I got a new job at hte end of April. My wife takes two prescription drugs, a name brand anti-depresant and a generic birth control pill. Between the time that I started my job and the time that we got our prescription cards in the mail, she had to fill both prescriptions. The directions on the company web site says all you have to do is fill out a form and attach a copy of the receipt from the drugs and fax it in.
So, I do this. They've had the materials since June. In July, we received a letter in the mail saying it was being reviewed and that we needed to provide the pharmacy number to them. So, my wife had to trek back to Target to the pharmacy, explain what happend, beg them to fill out this form, and then take their abuse for not having an insurance card to start with... which was in the mail.
So, I submit this form and then sort of forget about it. I call up Aetna two weeks ago and they can't find my claim. The lady puts me on hold for 20 minutes and finally says that she found it, but that for some unknown reason, the paperwork was just sitting there. No reason it wasn't processed, it just hadn't been. She gives me a ticket number and says she will call me in a day or two. Of course, I never heard back.
So, I call again today. The person puts me on hold for 1/2 hour (literally) and finally tells me she can't find my claim... that it has disappeared. She says that I'm going to have to fax her another copy of the materials. So, after telling her just what I think about Aetna in general, I explain to her that I have a ticket number. The woman last week was reading the documents. Of course they have it. So, I tell her I'm absolutely not going to fax her anything and she is going to find this. She then puts me on hold again for about 5 minutes and comes back and tells me that I have the wrong department. I need to talk to the drug area. She is the medical area. Umm... why didn't you tell me that before? Why did you dialer thing put me in to you?
So, I get this other guy on the phone, who puts me on hold for another 5 minutes and he finally comes back and says that my one claim was processed on July 23rd. So I say, well were is my money. Do I get a check? He says no, you have to wait until the other claim is processed. And I say well when is that. And he says well, what do you know, it was processed just yesterday (ya right). So, I should be getting my check in the next couple of days. I'm not holding my breath.
My point here is that if this is what I have to go through to get my little $150 reimbursement, I can't imagine what it is like to have real medical issues that require constant dealings with these insurance companies. I was just talking to a co-worker whose husband is a family practice doctor who said he fights with them on a daily basis about much more rediculous things than this.
I'm not understanding how compaired to a single payer system a for profit system a) benefits consumers and b) is more efficient. There is no way. Also, just the headache of having to deal with these things is rediculous. I've wasted an hour today dealing with this, plus the 1/2 hour I wasted before, and all the headaches of submitting the claim / resubmitting the paperwork.