New Insurance, New Troubles?
Last updated: February 2021
I recently got a full-time job as an Assistant Director with an office of research down in Florida. This was such a great opportunity, and I’m incredibly excited to begin my new job. With a new job comes lots of great benefits, one of those being a new health insurance plan (a great one too since I technically work for the state of Florida).
What I hadn’t realized, however, was the difficulty that I would face in transitioning from my old insurance plan to this new insurance plan. From getting a new prior authorization request for my Humira to changing all of my prescription medicines to a new pharmacy insurance, this process has been cumbersome.
I do want to add an important caveat: I am incredibly grateful to have my new insurance and don’t want to come across as if I am ungrateful. I just want to convey my frustration with the insurance industry that we have here in the United States.
A delay in my insurance benefits
I enrolled in my insurance plan for my new job earlier in the month. I was supposed to receive a call from the new insurance to set-up my benefits (and was told that that would happen approximately five days after I enrolled in my new plan).
Well, after six days of not getting a call, I gave them a call-back to ask about the status of my enrollment. They told me that since I enrolled in the middle of the month, my benefits wouldn’t start till the next month (November), which was not what I expected.
I explained to them that this put behind my plans for requesting prior authorization for my specialty medication and for changing all of my insurances to a new pharmacy. Admittedly, there was nothing they could do about that, but it was at least nice to air out some of my frustration.
Waiting longer for a prior authorization
There are so many complicating factors to this story in having to wait longer to get prior authorization for my Humira prescription that doesn’t really seem to be understood by any insurance company.
I need my medication to live, and I only have a limited supply available (thankfully I have a two month supply ready from my old insurance). So, waiting another three weeks to even begin the process of transitioning my health insurance can potentially put my life on hold and in danger. While I’m thankful to have an extra supply of Humira, it’s scary to think about how something that I am relying on to function could so quickly be taken from me.
My RA care is dependant on insurance companies
Moreover, I never realized how dependent I was on these medications and their schedules and, more importantly, the insurance companies deeming what I can and cannot use to heal my body.
Part of this problem begins with the very shocking price tag of $10,000 or more for a two month supply of Humira. And while I’m incredibly privileged and grateful to have an insurance company that covers most of that cost for me, it doesn’t negate the fact that these drugs should not cost that much.
I’m hopeful for a resolution to my situation soon. I believe that it will come (and that maybe this is a lesson in patience as a virtue) but sometimes when your life is the very thing in danger, it’s hard to have patience.
Did you know rheumatologist Dr. Donica Baker is answering community questions?
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