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Really Blue Cross?

One of the side effects of chemotherapy is nausea.  It can be debilitating.  During my treatment, they gave me two different anti-nausea medications before I was given the actual chemo.  I was also prescribed two anti-nausea medications to take as needed after treatment. 

I was told to begin taking them immediately to get a jump on the nausea.  Even if I didn’t feel nauseous, I was to take the meds.  I questioned the logic but am so glad I listened.  When the meds wore off, the nausea hit.  The meds were a god send, they helped immensely.  Thank God for drugs!

After the first round of chemo, I found that I needed the meds more right after a treatment.  The nausea wore off at the end of the two weeks (I was on a two week cycle).  I took them religiously during the tough days, I even set my alarm and would take them in the middle of the night so I didn’t wake up ill.  I also took a stool softener and no we’re not going there! 

I had done my first cycle and was going in for another treatment, when I called to have my script refilled.  I only had a few left and wanted to be prepared for my next round of chemo.  My pharmacy called me and informed me my insurance wouldn’t cover my script.  When I asked why, I was told I was only allowed to have 30 pills every 30 days.  Are you kidding me?!?  I was taking three pills a day for the first week to fight the nausea.  Those pills were saving me, I really needed them.  I called my insurance.  What I really wanted to do was speak to the yahoo that made that edict.  I wanted to ask that person if they had ever experienced chemo and its side effects.  I’m sure they hadn’t.  No one who experiences this would ever withhold medication from those in treatment.  I plead my case with the girl on the other end.  She overrides the order and my script is sent to the pharmacy.  All is right in my drug world.

When I went for my third round of A/C.  I thought my script nightmare was over but that wasn’t the case.  I was turned down again.  I called and was told that I could ask for a review.  I filed for a review.  I got my oncology nurse involved and I was finally given a script.  But get this, they will only give me 30 pills.  Even though I need more pills to help me through, it’s only 30 pills every 30 days. 

I’m on my final round of A/C.  The next round of Taxol is not supposed to make me nauseous.  I just need one more script to get me through.  I’m once again turned down.  I’m angry and in tears.  My insurance company is willing to fork out thousands of dollars for chemo but will not allow me to have more than 30 pills to treat the side effects from the chemo.  Really?!?

I have some pills left from the last script.  (I’ve rationed my pills in case I couldn’t get any more).  Once again, I’m not allowed to fill my script.  I’m two weeks early. Thank God for my oncology nurse, she goes to battle for me.  She gets both the pharmacy and Blue Cross on the phone.  They go round and round and finally Blue Cross relents and will give me 20 pills, not 30 but 20.  Seriously?!?   Beggars can’t be choosy and I gladly take what I can get.

I will never understand insurance companies – EVER! 

And by the way, I received a letter from my insurance company that my case was reviewed it was deemed that the script for 30 pills was to remain.  The diagnosis didn’t justify the need for more medication.

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