Category: Insurance

Yesterday, some stuff at the pharmacy was… available, not available, available, not available … Please Call Anthem.

Sigh! 32 minutes on hold with Anthem.

“Hello”

“Hi there, could you please explain why I’m having problems at the pharmacy now?”

“On moment, Ah here it is, you haven’t Opted out of the Express Scripts Mail order service.”

“Ok, Let me explain something to you in no uncertain terms. If you force me to deal with Express Scripts I will cancel this policy.”

“Oh you’re not being forced to use them, you just have to opt out.”

“In other words you’ve signed me up to use their mail order service without bothering to tell me about it. Otherwise I wouldn’t have to Opt out.”

“Oh no Sir, all our clients have the option to use Express Scripts, you just have to tell us you don’t wish to use this valuable service.”

Briefly, I think about going ‘round the maypole again but obviously the nice lady at Anthem doesn’t understand my meaning about needing to Opt OUT of something versus choosing to Opt IN to something.

It would be a long conversation that dealt with the English language and fundamental rights, such as the right to privacy. Banking and credit cards spring to mind.

I’d, until the past decade or so, operated from the position that my account information, purchasing habits, or even the fact that I did business with a particular bank or credit card provider was private.  

Then I started receiving bank privacy notifications and forms that needed to be returned to Opt Out of them sharing my data with other companies.

While at the same time a certain bank of note started sending demanding e-mails and text messages once a quarter to Opt IN to their saving programs. Of course I’d like to save 5% on my purchases. Why do I have to re-affirm this every freaking quarter and WHY do they use words like madatory and Action REQUIRED in their quarterly reminders?

Why do they only bug me once a year, in very fine print to opt out of their selling my personal information? It seems backwards to me but then again I’m an old fuck.

I decide that the Anthem girl probably wouldn’t get it. She sound likes she’s in her 20’s. For her my explanation wouldn’t make any sense.

She’s from an age where its common place for ex-boyfriends to put naked photos of her or movies of them screwing on the internet. 

Privacy means considerably less to her generation than it does to mine. 

I doubt that she’d even understand the subtly of difference between opting out of something versus opting in to something.

“Ok, can I please Opt out of this fine service?”

“Certainly Sir, here’s the phone number to call, Please hold; I’ll try to transfer you to them.”

While I’m on hold listening to Muzak, I’m thinking that If this is what I have to do to deal with the insurance company, then if I were a doctor multiplying that by 100 or 1000 I’d never get any work done.

As it is, just trying to keep the ballon of my personal insurance in the air is stressful and time consuming. I’m wondering, “what are they going to screw up next?”

I’m also thinking it’s time for me to start shopping around for an insurance company that doesn’t require all this maintenance. Of course I realize that’s probably a pipe dream.

I begin to understand why so many doctors are just tired of the whole damn system.

I think of a childhood doctor, He was in private practice for a few years and I liked him. He’d been a military doctor, when he was just out of med school. After a few years, he gave up his private practice and went back into the military. I assume that’s where he finished out his career, by now he should be happily retired. I remember at the time wishing that he & my mom would start dating. I liked and trusted him.

“Sir? I’m sorry, but that department at Express Scripts is closed.”

“Fine, thank you for trying. I’ll give them a call myself in the morning.”

I can’t help thinking that this is all far too complex to be in my best interests.

I’ve been on the phone with Anthem at least once a month since November.  They claim all this chaos is due to Obamacare.

I’m sure that at least part of it is, but I’m equally sure that Anthem and other insurance companies are making things more difficult for consumers.

After all what better way to have Obamacare repealed than to inflict pain on the consumers who also happen to be voters.

I’m sure that the insurance companies aren’t losing any money due to Obamacare.

I keep thinking of the way gas prices go up. The oil companies jack the prices to obscene levels, then keep them there for a month or two. Then they drop the gas prices back to .20 above what they were before the run-up.

We idiot consumers breath a sigh of relief because the prices have dropped but we’re still paying more at the pump than we were.

I wonder if the insurance companies are attempting a similar gambit Obamacare jacks the prices and inflicts a lot of pain for the consumers. Then Obamacare gets repealed and the prices drop some and we think “ahhhh that’s better,” then move on to the latest idiocy of the Kardashians.

This morning bright & early I call the number I’ve been given to Opt-out of Express Scripts ‘wonderful’ service.

While I’m navigating the obligatory voice prompt system; I’m thinking that the local pharmacies have been taking it in the ass because of companies like Express Scripts.

Even the big chains are feeling the pressure and the little independent pharmacies are almost gone. Where is the protest against that? Right, I guess it’s not high profile enough to draw the ire of the Occupy protesters.

“Hello this is Mark your pharmacy advisor.”

“Hello Mark, I need to opt out of your service.”

“I’m sorry to hear that sir, we do provide a more convenient service providing you with a 90 days supply of your prescriptions via mail. First I’m going to need to know who you are and your date of birth.”

Note to self: Date of birth has become a piece of data that should be protected. This guy is looking me up with my name and date of birth. Come to think of it that’s all the insurance company or medical practices ever ask for.

I provide the requested information.

“Alright sir, could I ask you to hold for a minute or two?”

“Sure,” I reply, wondering why it takes a minute or two for him to click a check box on a computer screen. But then again this IS Express Scripts and I know how royally fucked up they are.

“There you are sir, you’re opted out. I’d like to remind you that we’re here should you change your mind.”

“Not going to happen,” I growl.

“Might I ask why?”

“You people screw up all the time. You screwed up my RXs and changed the drug I was taking to another drug claiming it was the same. Look man, if the drug has different chemicals, they’re not the same, they’re different. Here’s an experiment for you, try taking estrogen instead of a testosterone replacement and tell me how that goes for you. They’re both hormones just a little different.  Then there’s the whole question of your being able to keep records. Your RX by mail online history was always wrong and that begs the question about your ability to detect a potential drug interactions. No, I will not deal with you. I’ll continue to go to my local pharmacy and be able to talk to my pharmacist. You might also want to note this, if mail order through your company ever becomes mandatory through this Anthem policy, I will cancel the Anthem Policy just to get away from you!”

“Er, Um… I’m very sorry for the difficulties you’ve had in the past. Please remember we are evolving and our procedures are getting better all the time. So if you ever change your mind we are here.”

I give him props for his recovery.

“Thank you. By the way, it’s nothing personal it’s your company.”

“Have a nice day sir.”

“Thank you and you do the same,” I hang up. 

Hopefully I won’t have to call Anthem until later in the month, next month.I’ll wait 24 hours then see if all in my insurance world has returned to normal.

I have no need, as far as I know, to call Anthem. I’m penciling them into the calendar just because I KNOW something will go wrong and I’ll spend another 30 minutes to 30 hours dealing with them.