HealthNet screws us again

tl;dr: HeathNet sucks ass.

Long version:

So, Kris has had poison ivy going on ten days now. He's been miserable in more ways that I can think with his swatch of infected area, now ranging in the size of 10" long by about 4" wide, much of it raised, bumping, oozing and inflamed. After a week of calamine lotion, cold compresses and increasingly ineffective benadryl, Kris finally took my suggestion (my increasingly insistent suggestion, because we all know how stubborn boys can be) and called his dad for help.

On Friday, Kris' dad called in a prescription (yes, having an allergist as a father is fabulous), which Kris filled and immediately used. Given the large areas of infection (that 10" x 4"? that's one of THREE that size), he ended up using just under a third of it on the first application. Now, if the prescription, a lotion, was to be used only three times, this would have been fine. However, the instructions said use twice a day, he had huge areas to cover, and the irritation/infection had spread to the point of ridiculousness, three times was not going to cut it.

And it didn't.

Two days later, Kris was about to run out of the lotion. I called the pharmacy to refill the prescription and was told the prescription could not be refilled for thirty days.

WHICH rather defeats the purpose of having a lotion that both relieves the itching of an intense infection and cures it, if you can't use it FOR 30 DAYS.

Right.

I told Kris I couldn't renew the prescription, to which he speculated that a second prescription may have caused the delay in refill availability. He said he'd call the next day, not to worry.

Boy, was he wrong.

Despite the immediate need for the prescription, and the doctor's declaration that a refill was authorized, the F***ING INSURANCE COMPANY decided that one fill is sufficient, they would pay for only one refill. Worse, the pharmacy became unwilling to refill the prescription without the F***ING INSURANCE COMPANY's authorization.

Kris and I are lucky enough to both have the resources available to us to pay for the refill out of pocket, enabling Kris to get relief. However, not everyone is in that position. For those that can, great, fill and move on. For those who aren't, you have to ask, WHY IS THE INSURANCE COMPANY DETERMINING HOW MANY TIMES A PRESCRIPTION CAN BE FILLED?

Why is the insurance company determining what care a patient receives?

We're talking a $50 tube of relief. We're talking a non-addictive, non-abusive medicine. We're talking a medicine that can't wait until an insurance company decides it's "okay to provide."

We are, at this point, three for eight on successfully submitting claims with HealthNet. That 7% limit before you can start taking deductions on your tax return? One emergency this year and we'll be hitting that, given the crappy coverage with HealthNet.

Having coverage with HealthNet is the equivalent of having no coverage at all. There, that's my tweet.

I take back whatever complaints I had with BlueCross. At least they provided coverage.

P.S. And, yes, following my belief, "If you need to complain, you need to do something to solve the problem," Kris and I are looking for real coverage.

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