Window Shopper

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For those of you who do not take any type of meds, this will seem possibly trivial but for those of us who are on medications 24/7/365 it is a pain in the posterior and other places too. This has been a running problem for me for years. You go to the doctor, he/she gives you a prescription that, sadly, you have to take every day of the year.

The rub? Each and every prescription is written for a 30 day supply of medication. That’s great. Has anyone looked at a calendar lately? There are 4 months of the year that are 30 days long (April, June, September, November). There is one month that either has 28 or 29 depending on whether it’s a leap year or not (February). And there are 7 months of the year that are 31 days long (January, March, May, July, August, October, December). Clues anyone? Those are the months when you will find that you do not have enough medications to make it through that particular month. Why is this?

1) Because the doctors are not about to change it. They have done this for years and are not about to stop it.

2) Because the government, in it’s ridiculously infinite wisdom (Laughing so hard she falls to the floor laughing hysterically), has decided that they are not going to pay for medications for more than 30 days at a time. Never mind that it is going to hurt people. It’s just done that way.

3) Because the drug companies like it that way. No known reason other than it’s always been that way. Got any ideas why they would want it that way?

4) Because the insurance companies are not about to pay for more than 30 days at a time.

The reality is that for 7 months of the year, I am coming up short on the medicines I take because most of the months are 31 days. I am not alone in this. And people on Social Security are hit particularly hard with this. I should know. The government, as in Part D insurance, will NOT allow anyone to get their meds early, no matter what. I have run into that several times now. And in effect, I have lost 7 days of the year on medications. Now, the doctor requires me to take them every day of the year but he doesn’t apparently feel the need to write a prescription for every day of the year. Even if he did, the government would not allow me to have it before the day it’s due to be renewed. Well, I have gotten it a couple of days ahead. There is not a lot of leeway there.

How about some sanity here. Doctors, government, insurance companies….GET A CLUE!!!! People on lifelong prescriptions, I realize that this is not an earth shaking problem but it is a problem. It needs to be addressed. Call or write your congressperson about this. This is insane! And really, really stupid.

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The first thing I want to say is..please, please do your research about insurance companies. A woman who had been insured for some time for disability insurance contacted her insurance company because she needed some cancer related treatments. She had stage 4 metastatic breast cancer and it was spreading all over her body. The insurance company began requiring her to send information. They needed more information.

After several months of doing such things, they denied her the short term disability money she needed at that time. It was due to the fact that despite all the forms she filled out and sent it, she had not proved to their satisfaction that she was disabled. The company she had worked for could not give her another job. She was unemployable. Yet, the insurance company said she didn’t prove a disability.

In the meanwhile, bills were piling up. As the insurance company kept stalling her by asking for more and more information, she was losing one thing at a time and the bills kept on coming. So, she hired an attorney. She then filed for long term disability instead of short term. Her policy stated that she would receive 60 percent of her salary if disabled. Said insurance company then objected to her situation saying that before all this, she had another form of cancer that is unrelated and therefore is not eligible for the insurance coverage. She had been cancer free for some time prior to all this.

The thing is, if the insurance company can delay and deny claims or pepper the claimant with all sorts of delaying tactics, the claimant will likely give up and go away. Many insurance companies hope you do that since then they do not have to pay out a claim that the customer has paid premiums on for years to that company. The problem is that there is no law or oversight group to change this. No one is going to force the company to do the right thing. Therefore, they can pretty much do as they please without penalty. They can be dog-slow and no one can change that. They can pepper you with all sorts of forms to fill out. You can be at that for months before they decide to say no to discourage you. And there is very little you can do about any of it.

Unfortunately, this can be a life or death situation for many people who need the money to survive. Many do not because the insurance company bets that you will die before you can make them pay out to you. I firmly believe that there ought to be more regulation on the industry. Such companies should be required to answer claims within a short period of time. They should be expected to get all of the information that they need right away and make such decisions based on the claim rather than their pocketbooks. This SHOULD happen but it will not. This is as difficult as it is to make the oil companies pay us back for all the money they have been ripping off of the people at the gas pumps.

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