A hot flash here, a hot flash there, here a flash, there a flash, everywhere a flash, flash. So goes menopause.
For sometime now Iâ€™ve been using bio-identical progesterone and estrogen to calm my menopausal symptoms with great success. The hormones are prescribed by my midwife/nurse practitioner and compounded by a pharmacy near the Twin Cities. My insurance company gave me no issues about my prescriptions until January, 2014.
After a request for a routine refill, the pharmacist, Laurel, contacted me a few days later.
â€œWe are having a problem with your insurance company. They say your Rx is no longer covered. Iâ€™ll try to send it through again, and Iâ€™ll also contact your healthcare
Provider to if there is anything she can do on that end.â€
I was impressed by her level of service, told her so, and waited to hear some good news. After a week of silence I called the clinic and asked if they knew anything. They said they were getting the run around from BC/BS. Had I contacted my pharmacist, and had I considered going on synthetic hormones because those would be covered?
Here we go, I thought. A pharmaceutical driven prescription instead of what I want. Why are my choices shrinking in my healthcare? I firmly said â€œnoâ€ to the synthetic hormones.
I let another week pass and then called Laurel. She confirmed that repeated efforts from her and the clinic to get coverage for my estrogen were going nowhere. â€œItâ€™s not just you, Gail. Iâ€™ve been having trouble with other womenâ€™s prescriptionâ€™s as well. Suddenly BC/BS wonâ€™t cover compounded hormones. It makes me mad, and I hate to seem them win if we just back down.â€
After a lengthy discussion with Laurel, we decided to get an Rx from my healthcare provider for a bio-identical estrogen patch. I believe I am paying for my choice out-of-pocket, but will know after I see the bill.
In a fit of frustration I also wrote to my senator letting her know Iâ€™m troubled with this trend in insurance and healthcare. Iâ€™ll let you know how it goes, or if it goes anywhere. I had to at least try.
Here is a copy of the thank you note I sent to Laurel for her caring attitude and extraordinary care:
Your above and beyond service matters
a great deal to me in an age laced with
indifference. It would seem insurance companies
have lost track of their purpose. At one point
insurance was an option that helped people afford
needed medications, and now they are in the
business of telling people which medications they
may have, and who they may buy them from.
So thank you for trying to get my Rx through
Blue Cross and Blue Shieldâ€™s, well, shield. I also
appreciate your conversations with my healthcare
provider on my behalf, and your phone instructions
on the use of the patch. While I canâ€™t promise my patch wonâ€™t
end up on my husbandâ€™s anatomy during sleep, I will let you
know if he grows breasts anytime soon. â˜º
With admiration and gratitude,