
There are many people out there who do not believe that our
Healthcare System needs reform. They believe that the free market will police itself. If you are one of those people then I hate to break it to you but you’re wrong. Here is one shining example of why the Health Care Industry needs oversight and reform.
I’m your typical American, middle class worker. I’m employed by a large company
and medical insurance is part of my compensation package. My prescription drug coverage is
provided by CVS Caremark and for this coverage I pay big bucks every month.
For the past few years I have suffered with a condition that makes it difficult for me to breath.
I’ve tried tons of over the counter and prescription medications but nothing ever helped.
Recently I went to an allergist who after intense evaluations prescribed Qnasl, a steroid aerosol.
Finally, something that works! After years of suffering and Multiple doctors I now found something
that works. I was very excited to say the least.
When I went to my local CVS to fill the prescription the pharmacist informed me that the insurance company would not cover the medication. I was dumbfounded. Why? They told me that my doctor must first contact CVS Caremark and confirm the necessity for the drug. A board certified doctor writes me a prescription and that’s not confirmation of necessity? I just didn’t get it. I was faced with either paying for the medication out of pocket or going without. I shelled out the $180 dollars and left. I’m lucky in that I can afford to pay. Many people cannot and are forced to suffer.
After going back and forth with the insurance company they informed me that I had to go back to all my doctors and get documentation of all the other drugs I have tried, cheaper ones, before they would agree to
cover the medication that I needed. I was to jump through fiery hoops until CVS Caremark was satisfied that they couldn’t get out of meeting their obligations.
I received a form letter from CVS Caremark stating that I had been denied coverage. They told me that I could appeal the ruling and graciously added that if I was in severe discomfort or pain they would expedite the appeal to 15 days. How nice of them that they would only allow me to suffer two weeks or so if I was in severe pain.
Make no mistake. This is purely a game of profit. They believe its unreasonable to pay one hundred and sixty five dollars for my medication but it's perfectly ok that Larry J. Merlo, Director, President and Chief Executive Officer CVS CareMark, made more than 54 million dollars in executive compensation in the four years 2007 -2011.
Thats FIFTYFOUR million dollars!!! CVS Caremark shelled out over 230 million dollars in compensation to key executives in that same time period. That money could have purchased a lot of badly needed medication for a lot of people.
It’s all about profits over people. CVS Caremark is not alone. They are but one example of an industry that profits from the pain and suffering of others. Corporate bean counters making decisions about your healthcare regardless of what your doctor prescribes.
CVS Caremark and their ilk are the true death panels.
--------------------------------------------------------------------------------------------------------
Update 4/3/2013: My doctor called to say the insurance company finally agreed
to cover the medication. After 3 weeks of back and forth they agreed. In
anticipation of their douchyness my doc game me a 6 month supply and the drug
company themselves offered to pay for part of my prescriptions so too little
too late from CVS Carmark. In the end they got what they wanted. They were able
to shuck their responsibilities and screw the little guy.
Healthcare System needs reform. They believe that the free market will police itself. If you are one of those people then I hate to break it to you but you’re wrong. Here is one shining example of why the Health Care Industry needs oversight and reform.
I’m your typical American, middle class worker. I’m employed by a large company
and medical insurance is part of my compensation package. My prescription drug coverage is
provided by CVS Caremark and for this coverage I pay big bucks every month.
For the past few years I have suffered with a condition that makes it difficult for me to breath.
I’ve tried tons of over the counter and prescription medications but nothing ever helped.
Recently I went to an allergist who after intense evaluations prescribed Qnasl, a steroid aerosol.
Finally, something that works! After years of suffering and Multiple doctors I now found something
that works. I was very excited to say the least.
When I went to my local CVS to fill the prescription the pharmacist informed me that the insurance company would not cover the medication. I was dumbfounded. Why? They told me that my doctor must first contact CVS Caremark and confirm the necessity for the drug. A board certified doctor writes me a prescription and that’s not confirmation of necessity? I just didn’t get it. I was faced with either paying for the medication out of pocket or going without. I shelled out the $180 dollars and left. I’m lucky in that I can afford to pay. Many people cannot and are forced to suffer.
After going back and forth with the insurance company they informed me that I had to go back to all my doctors and get documentation of all the other drugs I have tried, cheaper ones, before they would agree to
cover the medication that I needed. I was to jump through fiery hoops until CVS Caremark was satisfied that they couldn’t get out of meeting their obligations.
I received a form letter from CVS Caremark stating that I had been denied coverage. They told me that I could appeal the ruling and graciously added that if I was in severe discomfort or pain they would expedite the appeal to 15 days. How nice of them that they would only allow me to suffer two weeks or so if I was in severe pain.
Make no mistake. This is purely a game of profit. They believe its unreasonable to pay one hundred and sixty five dollars for my medication but it's perfectly ok that Larry J. Merlo, Director, President and Chief Executive Officer CVS CareMark, made more than 54 million dollars in executive compensation in the four years 2007 -2011.
Thats FIFTYFOUR million dollars!!! CVS Caremark shelled out over 230 million dollars in compensation to key executives in that same time period. That money could have purchased a lot of badly needed medication for a lot of people.
It’s all about profits over people. CVS Caremark is not alone. They are but one example of an industry that profits from the pain and suffering of others. Corporate bean counters making decisions about your healthcare regardless of what your doctor prescribes.
CVS Caremark and their ilk are the true death panels.
--------------------------------------------------------------------------------------------------------
Update 4/3/2013: My doctor called to say the insurance company finally agreed
to cover the medication. After 3 weeks of back and forth they agreed. In
anticipation of their douchyness my doc game me a 6 month supply and the drug
company themselves offered to pay for part of my prescriptions so too little
too late from CVS Carmark. In the end they got what they wanted. They were able
to shuck their responsibilities and screw the little guy.