Published on August 9, 2018
Frustration, anger and confusion, these were just a few of the emotions I felt when I went to refill a prescription at the pharmacy. I had been taking the medicine for almost 10 years, only to find out my insurance had no longer approved it for coverage. Nothing had changed to my knowledge, yet the pharmacist at my local Walgreens informed me that I did not have access to this medicine.
The next month consisted of many calls back and forth with the insurance company and my doctor. I ended up waiting nearly a month to get in with a doctor to try and fill a new prescription, only to wait three hours in the office and then to not be seen. At this point, those emotions had become much more intense, as I felt I was wasting both my time and energy dealing with an issue I believed was unnecessary.
Through a long drawn-out phone call with my insurance company, lasting almost three hours, I spoke to five different people explaining my situation. Again and again, I was told I would need to have another appointment to access my medicine, but an appointment was not available in my area for another month. This was not a wait I was willing to accept. Every time I spoke with someone I asked the same questions, and eventually asked to speak with the next higher-up.
By the end of my phone call, I was assigned an appeals manager for the claim I was then filing, now I thought hopefully we were getting somewhere. Just before getting off the phone, I was told this appeal process could also take up to one month. Again, I felt defeated.
I hung up the phone after this saga, frustrated and deflated. I took to the Internet and tweeted at my insurance company. “Withholding access to a medicine I need over technicalities, completely unacceptable. This is not right.” Within 15 minutes, I received a message “please direct message us your phone number and member number, we would like to follow up on this issue.”
After some messages back and forth, within the hour an agent from my insurance company called me to discuss the previous events and issues. Over the next three days, the agent worked on getting me access to my medicine. She contacted my doctor, worked with the insurance company, and ultimately was able to get approval for a peer-to-peer prescription to be written so I no longer had to wait for another appointment.
I had access to my medicine again.
This process was frustrating and exhausting, but it does have a happy ending. I feel sad for patients who have to face these issues with not only access to medicines but in all areas of their healthcare.
It is important to remember not only to advocate for ourselves as patients to our doctors, but in all areas of our care. To persist if we think something is not right and speak up when we know something is wrong. Patients withall types of conditions have access issues, but together as patients we can stand up, speak up, and help pave the way by advocating for ourselves.
Have you had an issue with accessing care or your medicines? We want to hear from you! Comment below.
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