My Experience: Update

by Karoli on September 22, 2005 · 84 comments

After several rounds on the telephone today, I discovered that the price on the Adderall was what it was because they claimed I hadn’t met my deductible. The REASON that I hadn’t met my deductible was because I paid cash for the ADHD prescriptions all year.

Since they didn’t go through the PA process (because it was painful enough last time to be turned down), they are not counted against the deductible. Period, and no exceptions.

If I have this right, the deal is that the deductible only applies to medications which have been either approved or disapproved whether or not they are covered or prescribed by a qualified and licensed health provider. Okaaaaaaaaaaaay.

The debit card situation is a bit weirder. No one can seem to track a transaction from start to end to see what’s broken. I did finally get someone on the phone who said she’d try to, but no guarantees. That’s just peachy-keen. No guarantees….

You’d think there was one person out there with a small, tiny clue about how to get this resolved. Stay tuned.

I am also forming the “what we can do” piece of this series. I’m trying to do some real research into what advocacy groups exist. I can write all day long about ERISA remedies, but this is really bigger than one plan. At least, it is to me.

In the meantime, my thoughts, prayers and love go out to those in the path of the new hurricane, Rita. Be safe, be strong — and we’ll support you in whatever ways we can.

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