A few weeks ago, I had an appointment with my doctor. I inform her I have not been on the medication for 6 weeks because my insurance has denied coverage of the drug. My symptoms have been progressively getting worse. She tells me she will submit another prescription to my pharmacy.
A few days later, I receive a bill from my specialty pharmacy. Yes, my insurance had denied coverage of the drug last fall. I am now responsible for the balance. I call the pharmacy and explain my situation. I am simply told the claims were submitted; my insurance rejected payment. I call my insurance. I get no resolution from my insurance. I call back the pharmacy and ask them to resubmit the bills to my insurance. The customer service representative tells me the bills were submitted. The claims were rejected by my insurance. She does not give me an answer if the bills are going to be resubmitted. I end the call and give up for the day.
A week later, I get another notification from the pharmacy that I need to pay my bill. I call the pharmacy. I explain the whole situation and ask for the bills to be resubmitted to my insurance. The woman says she will forward my account on to someone who deals with insurance issues. I should hear back from the pharmacy in 30-45 days.
An hour later, I receive an email notice from the pharmacy that my medication has been shipped out. I am confused. How can this be? I did not authorize them to send out any more medicine. I immediately call the pharmacy and ask for the shipment to be stopped. I inform them I cannot afford the drug. The woman says she will work on it...but I know it is too late. The tracking on my package says the medicine is already at the airport waiting to start its overnight journey to my house.
The next day, ding, dong. The package is left on my porch. The delivery man quickly scurries away to his truck before my mom can get his attention to return the package back to the sender. I immediately call the pharmacy. I spend nearly an hour on the phone. The man says he needs to contact his supervisor. He will call me back. I wait and wait. No one calls me back.
The next day, I again call the pharmacy. I explain I cannot afford the drug. The pharmacy sent out the drug without my authorization. I again spend many, many minutes on the phone on hold. Finally, the customer service representative comes back on the phone.
Customer service representative (CSR): "One of the problems is you have two accounts. I do not know why you have two accounts, but that is making things confusing. I do not know why you were sent out the medicine without someone contacting you. It is our policy that someone calls you to make sure we are sending it to the right address, to make sure someone will be home when the drug is delivered (the medicine needs to be refrigerated), to make sure you are not having an allergic reaction to the medication, to make sure you can afford any possible payments associated with the drug so that a situation like this does not happen...Do not send back the drug to us. If you do, we will have to destroy it. Instead, take the medicine."
Me: "Will I be responsible for the cost of this drug? I did not want the medicine. I cannot afford it. No one called me for authorization."
CSR: "Well, because you did not contact us, informing us that you cannot afford the medicine until after we sent out the drug, and if we cannot get your insurance to pay, you will be responsible for the bill."
Me: "But I did not want the drug sent out. No one contacted me. How was I supposed to know y'all were going to send out the medicine?"
CSR: "Yes, that is unfortunate. I do not know why no one called you. Our policy is to call before we send out the medication. We will try to work with your insurance to get payment. Just take the drug as prescribed. It's important you take the drug. That's why we sent it out. We do not want you to be without the drug."
Me: "But if you cannot get my insurance to pay, I will be responsible for the bill?"
CSR: "Well, umm, yes. But don't worry about it. Just take the medicine."
I ask that a note be placed on my account that no medicine be sent out without first calling me and asking for my authorization. The CSR again says it's their policy to always call before sending medicine out, but he will place the note on my account.
I thank the CSR for his assistance and hang up.
I abruptly start laughing. Oh, this is so ridiculous! A company goes against their own policy sending out a drug, and then I am on the hook for the bill! How is this fair!? You can't just send me things in the mail and then demand payment. There has to be a law against this, isn't there?
Not knowing what else to do, I pray to God. "Well, this certainly is an interesting situation You have placed me in. I know all trials are from You. You know what my finances are. You know these bills will be a heavy burden on me. I know You can fix this...and that is what I ask. Please resolve this financial ordeal. Amen."
(Part One click here)
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