Friday, January 9, 2009

Prescription Fever

All right, someone help me understand this.

First, I have health insurance, and I understand that this is not a God-given right. Many people don't have it. But when you are fortunate enough to have health insurance, which includes prescription drug coverage, you believe - at least I believe - that an illness such as bronchitis, which I have, should be covered by actual prescription drugs, which is why I went to the doctor in the first place.

But a funny thing happened when, after the physician asst (reg. doc not avail on such short one-day notice) wrote a prescription for an antibiotic (co-pay $5), she then proceeded to rattle off a number of more expensive, over the counter medications as supplement medicines. This seemed weird to me, and she sensed my puzzlement, yet had nothing different to offer.

In the end, I spent $41 on trying to get better.
a. $10 copay at the doc's office
b. $15 for Mucinex, recommended by physician asst to break-up phlegm in lungs
c. $15 for Zyrtec, recommended to stop nasal drip at night so I can sleep

The odd thing is, I used to take Zyrtec, an allergy medication, but then it went over the counter and became more expensive. It's now basically $1 per pill. Before, it was $10 for 30 pills. When I asked for a prescription instead of Zyrtec, the p.a. wrote a prescription for Allegra, but said it was a third-tier drug and that my health insurer, ConnectiCare, which I like, wouldn't cover it. I asked her to write it, anyway, since I'd rather pay $5 for Allegra instead of $14 for Zyrtec. Perhaps it would work.

When I brought it to CVS, the pharmacist said that my insurance company was refusing to pay anything toward Allegra, and that, if I wanted, I could refute the decision, and that it would take two days to resolve it. So I'm supposed to wait and get more sick during this time? I told her to rip it up.

I ended up getting the Zyrtec, but the larger point here is that I don't need a professional at a doctor's office to tell me to get over the counter medicine. I want them to write me prescriptions so that my insurance company will pay for them.

Oh, well. My cough is breaking up today, thanks to the Mucinex (which has funny commercials). And I slept well last night due to the Zyrtec. The only thing I can't tell that's had any positive influence has been the antibiotic, which, if irony is cruel, I probably didn't even need in the first place.