Don't get me wrong. I'm a firm supporter of health care reform and the ACA. But some of this just boggles the mind.
(And I am not, in this post, even commenting on the special circle of hell we are undergoing to get coverage for our daughter. That's a whole other, as yet underdetermined, issue).
No, this is about the birth control pill (so dad, if it's too much information, you might want to stop reading now).
I've been on Sprintec for 7 years. My doctor first prescribed it because it was on the $4 formulary at Target. I think I wrote a post about it a few years back when Target stopped carrying it and I had to look all over for it, finally finding a CVS that carried it. But that was a whole other rant.
Under Medica, I used to get 3 months at a time, for $0 co-pay. Then, under Preferred One last year, I could only get 1 month at a time (presumably because people were stocking up or something? I don't know). Then I switched to Blue Cross Blue Shield this year, and picked up my first prescription last night.
First of all, it took over half an hour to get the insurance info changed (really?). Then, to my surprise, there was a $10 co-pay per month. BCBS provides 2 months, but I had to re-cut the prescription (which takes an amazingly long time) so I could only pay for one month while I worked it out.
20 minutes on hold to BCBS today revealed the issue. Yes, the cover birth control at 100%. But only SOME birth controls, on a special secret list that they only reveal to providers. No, of course Sprintec is not on that list. I have to contact my doctor and get a new pill prescribed, or have a "formulary exception" put through.
Never mind I've been on it for 7 years, or that it was initially prescribed because it was the cheapest (presumably for providers as well). Never mind that insurance only pays for one visit a year, so it would have been prescribed then (when it WAS covered) and it's hard to get a new prescription without another visit. Never mind I don't have access to that list, so now my doctor has to review my case and pick a new prescription and call it in, taking time from her other duties. Never mind that between the CVS, the phone call to BCBS, and the call to the doctor's office today I lost over an hour of time getting something I am entitled to and that we pay almost $1000/month for coverage for.
There simply has to be a better way.
ETA: Called my doctor. They don't have a list or access to that. I have to get that from BCBS. Currently on the phone with BCBS. They can't give me the list because it's medical information that consumers don't understand. Apparently I am supposed to just go to the pharmacy with a stack or prescriptions for various pills, then run each one through until we find one that has no copay. No joke.
Confidential to BCBS: It costs a lot more money for me to have a child than to take birth control….