Saturday, August 12, 2006

This is how we treat our vets?

Okay, so I was at work today and an elderly gentleman brought in a prescription for Plavix. As it happened, he was retired from one branch or another of the US military so he had coverage through .... well let's just say it's a major company that handles the Department Of Defense prescription benefits. Also as it happens, a generic for Plavix just came out - "just" as in we got it in yesterday. So we try to fill the prescription and the insurange company doesn't recognize the generic as a valid product. That wasn't too surprising because sometimes it takes the plans a little while to catch on to a new generic. So naturally we tried to fill it for the brand. This is where it got tricky. The insurance company refused to pay for the brand name Plavix because there is a generic available. A generic - that it doesn't recognize. Now, that's pretty stupid in and of itself. So I called the insurance company and was told by the person at their help desk that they couldn't override the claim. Presumably since it's Saturday, there was no one there to add the generic drug to the system either. So the lady at the help desk gave me another option. She told me that the patient could pay out of pocket for the drug and then be reimbursed by the insurance company some time in the future when they put the generic into the system. Oh yeah that's a good plan......... the generic cost over $100 per month. (Imagine what the brand would have cost!) Now I understand the real reason why retired military personnel aren't permitted to keep their old weapons as souvenirs.....

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