An email this A.M from my brother on our wonderful system of private insurance::
I had mom to the dermatologist yesterday. All her cancer lesions have healed nicely except for the end of her nose. We will do four more weeks of treatment (ointment three times a week), and I will bring her back to the doctor on August 5. Here’s a complication however. It turns out the prescription ointment is very expensive (her last prescription, which ran out a couple weeks ago) was over $600. The doctor’s office sent over some samples, which will last about another week. The doctor gave me another prescription, but the pharmacy at Billings H & R will not fill it because mom’s insurance (Sterling) turned down the claim on the first prescription and so Billings H & R is already out $600 on this deal. So I’m going to visit with the doctor and see if we can get some samples to finish out mom’s treatment, and also see if he will file an appeal with the insurance company to pay for the first prescription.
I had a nice visit with the pharmacist, who is really upset with Sterling, and with supplemental insurance in general. He said they readily approve prescriptions for cheap drugs, and constantly turn down prescriptions for expensive drugs. In his opinion if we don’t get a single payer, or at least a public option, we’re headed for increasing disasters. Don’t you love all the benefits free-market health care brings us!
We have been paying insurance premiums to Sterling (currently over $180 per month) for decades now. We do a lot for their bottom line. They don’t do a thing for ours.
Piece of Mindful 
Mark, first, I hope your mom comes out OK. I’m going through the same cancer with my mother – right on the end of here nose too.
Anyhow, and not to defend Sterling or any other insurance company, I wonder if that same script would be approved under the VA or Medicaid. My brother-in-law is under the VA system with all sorts of problems and there are a number of drugs that the docs think he needs that aren’t in the VA’s Rx formulary.
LikeLike
I forwarded the message. Thanks
LikeLike
Really—sticking with an insurance company “for decades” that keeps denying your claims. Not too bright. No sympathy from me.
Whining about money and making stupid investments must run in your family. It could be a genetic problem. And that will cost you a bundle to get fixed!
LikeLike
Why, if it isn’t Max Bucks! Missed you, cowboy.
LikeLike
Mark are you sure under Obama’s plan that your aging mother would be treated at all? Via Newsbusters.
Obama said during the ABC Special on Wednesday night that a way to save healthcare costs is to abandon the sort of care that “evidence shows is not necessarily going to improve” the patient’s health. He went on to say that he had personal familiarity with such a situation when his grandmother broke her hip after she was diagnosed with terminal cancer.
Obama offered a question on the efficacy of further care for his grandmother saying, “and the question was, does she get hip replacement surgery, even though she was fragile enough they were not sure how long she would last?
LikeLike
Swede – my mother is treated under the existing single payer plan. Not an issue.
What is at issue is skin cancer – there are different varieties and I don’t know that aggressive treatment is always warranted. Her cancer is either basal or squamous cell, neither of which, as I understand it, woudl warrant aggressive treatment in Canada. As family members, we opt to go with the most aggressive treatment. We need someone, anyone to step in and tell us that we need to not treat her disease.
It’s a problem. We are not dealing with it now. Obama, to his credit, is addressing this problem.
LikeLike
Mark, as one who has also experienced skin cancer, find a surgeon that performs “Mohs” surgery. http://www.mohscollege.org/about/
Check out Billings: http://www.billingsclinic.com/body.cfm?id=108
LikeLike
That’s not the point. A private non-medical entity overrode a doctor’s orders to preserve its bottom line. That’s why the post.
LikeLike
Mark, do what you want. I was just concerned about your mother.
LikeLike
This is an old post, so I hope your Mom is doing ok. Regarding those expensive prescriptions, there is a way to save significant $$ in that area…
The Mobile Rx Card is completely free and it can save you 10-85% on brand/generic prescriptions, smoking cessation aids and diabetes supplies. Get a card at http://www.mobilerxcard.com, show it to your pharmacist at time of service and your discount will be applied immediately. It’s that simple. Use your card over and over again, and you can even share it with your friends and family.
Everyone who tries this card is amazed at the savings. Give it a shot! Best of luck.
LikeLike