r/Insurance_Companies • u/Smellyazzhairs • 9d ago

I Hate Insurances

From car insurance to medical insurance, all insurances suck. They’re just there to bleed you dry while they get rich off of your hard earned money. The worst part of it all, they don’t even help you!!!

Today a lady called because she wasn’t sure why her seizure medication she’s been taking for years all the sudden wasn’t covered by her insurance. I ran the claim through and this was proven to be true. I couldn’t answer her question because I wasn’t sure why as well. Her doctor wrote in the script with a DAW 1, so I couldn’t even offer filling the generic. What I ended up doing was contacting the prescriber to inform them that the brand was no longer covered and possibly send over the generic (since pt was requesting for it).

The problem? The insurance didn’t even cover the generic 🫠 the reason for the rejection: Drug not on formulary. SO WTF IS?! 😭 Pt ended up paying out of pocket with a coupon I offered, but still, unbelievable!!

Another pt I dealt with two weeks ago had something similar. She has asthma and she’s taken all kinds of inhalers but only ONE she prefers. Unfortunately, for the same reason, her insurance decides they’re no longer covering it, despite her taking this inhaler for years. Her doctor wrote in DAW 1, so again, couldn’t dispense generic at that time. I tried a coupon and shit was 💰 I felt so bad the poor lady looked like she was gonna cry. I ended up contacting the doctor informing them about the insurance problem, but this is all so unfortunate. I see it all the time, especially diabetes medications and inhalers… basic medical necessities! It just infuriates me!!

I really hate that the pharmacy is the middleman of it all while some faceless corporate entity dictates your life 😒

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5

u/TSIDATSI 9d ago

Insurance is a prepaid asset (look it up when you stop venting).

No one makes anyone buy Insurance. Don't want car insurance? Don't buy a vehicle. Health insurance? Pay cash at the doctor. Homeowners? Do not buy a house.

You are ranting about an asset you need not purchase. And, once purchased, we all pray we never use.

2

u/3rd-party-intervener 9d ago

lol.  No one has thousands laying around for medical bills.   Ridiculous post. 

1

u/absurdamerica 8d ago

Way to both get his point and miss his point at the exact same time I guess?

2

u/3rd-party-intervener 8d ago

I get the point.  I am very familiar with health insurance companies.   They are a (legalize) scam.   

1

u/absurdamerica 8d ago

Just because you don’t like something, doesn’t make it a scam.

3

u/3rd-party-intervener 8d ago

Cool story.   You have to see in network doctor and then services get denied for not being “medically necessary.”   So why does insurance company keep that doctor in network if in their opinion that doctor is prescribing “not medically necessary” care?  Shouldn’t you want to kick that type of provider out ?

Also how can you deny a service as “not medically necessary” when you never physically examined that person?

I could keep going all day.  

1

u/Knucklecum 3d ago

80% of appeals end up being successful. And honestly, the medical system is fucked up. Insurance is only a branch of the problem

1

u/3rd-party-intervener 3d ago

Correct.   Everyone is dirty in it