I went to the pharmacy to pick up Ellie's new prescription for Prevacid (she has reflux). The pharmacy technician told me that Prevacid isn't covered by our insurance. I told her that I had specifically checked before having the doctor call in the prescription and our benefits did cover the medication. She picked up the phone to call the insurance company. This is the dialog of their conversation:
Pharmacy Tech: I am calling from such-and-such pharmacy in regards to Elizabeth P. Her date of birth is 2/4/07. Our computer shows that you will not cover her prescription for dissolvable Prevacid tablets.
Insurance Agent: That is correct. We don't cover Prevacid.
PT: Elizabeth's mother says that her benefits do cover Prevacid.
IA: Well, we do cover Prevacid, but only after generic drugs x, y, and z have first been tried.
PT: That won't work for Elizabeth because x, y, and z only come in pill form and she needs dissolvable tablets.
IA: She needs to try the pills first before we will cover the tablets.
PT: She can't swallow pills.
IA: Why not? (Obviously not connecting the dots...)
PT: Uhhh, because she is a baby... (waiting for them to put the pieces together; they don't) aaaaaand.... babies.... can't.... swallow pills.
IA: Well, Elizabeth's doctor must contact us and tell us that she is unable to swallow pills and explain why before we will cover the tablets.
PT: I just told you why she can't swallow pills.
IA: You're not a doctor.
PT: Okay, whatever (hangs up phone)
I could hardly stop laughing by the time the conversation was over. The doctor did indeed let the insurance company know that Ellie is in fact an infant, and that in his experience infants should not be expected to swallow pills.
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That is funny! I'm sure that the pharmacy tech was rolling her eyes and shaking her head. And I can only imagine the doctor's reaction! Now you know what happens to those people who graduate from flipping burgers at the local drive-thru! They work at the insurance call center. Lord help us all!
I'm glad you had your sense of humor with you. Usually, you have to stand in line to drop off your prescription, wait 30-45 minutes, and then stand in line at the pick-up counter--only to be told that they couldn't fill the dang thing.
One day, I dropped off my script, sat down in the chair across from the window, and waited the the 20 or 30 minutes (entertaining two kids in the meantime). After the assigned time, I got to the pick-up window and gave her my name. She said that they couldn't fill it because they didn't have any in stock. I asked the her why she didn't look out the window and see me sitting there for the last 30 minutes--and bring it to my attention. I stayed because they were about to close. Now it was almost 9:00, I had two kids who needed to go to bed, and I had to wrestle the dang script from them so that I could take it to a 24-hour pharmacy!
These things always happen when your baby is miserable and you need to get that first dose of something in your his or her system--sooner and not later. It must be one of Murphy's laws....
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