I had a doctor appointment yesterday for an annual physical. I am in fair health, for someone who drew my numbers in the genetic lottery. My dad and mom both have GERD, and I got it in spades. My insurance company has decided that Nexium is too expensive, so they are jacking around with my coverage to discourage me from taking it. Here is a letter I just wrote to my doctor, which is a follow-up to the discussion from yesterday, when I didn't have the letter from the insurance company.
TO: Dr. Doctorlady Withglasses
FROM: GDad Lastname
RE: Discussion
from 04/18/2012 about Nexium vs. insurance coverage
PAGES: 2 (this cover
and attachment)
Dr. Withglasses,
Attached is the letter from my prescription coverage plan
advising me that I need to consider alternatives to Nexium in order to keep
coverage. I see that I failed to discuss
this with you before April 1, as the letter mandated, but we’re close. I spoke to Kelly at CVS/Caremark this
morning, and she told me that I must have you call to provide a
pre-authorization to ensure that Nexium is medically necessary.
Item for discussion next time I see you – How is “pre-authorization”
different from your prescription? Isn’t
the act of writing a prescription regulated to the nth degree already, and don’t
you, as a doctor, have what amounts to a sacred trust to keep your patient’s
medical needs in the forefront? Kelly
seemed chipper until I questioned this, then she was a bit curt with me.
In any case, if you could do me the favor of calling
CVS/Caremark to provide a pre-authorization for GDad Lastname regarding my
Nexium prescription, I would greatly appreciate it. If you think another route is medically
advisable, please let me know. The
CVS/Caremark number is 1-800-[redacted].
Sincerely,
GDad Lastname
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