Group Health
Fucking Group Health.
So, my employer switched from Regence Blue Shield (good insurance) to Group Health (shitty insurance).
Because I want to keep my current doctors and pharmacy, I elected the Group Health PPO. So I go to Bartell Drugs to switch over, and while they show that they're covered under the plan, my medication is rejected.
I called the customer service line for Group Health, and went through their tree to the pharmacy section. They said that the problem was that I had an alternate insurance, and that that insurance had to be billed first.
I don't have an alternate insurance, and this Group Health insurance would be my primary anyway.
She can't tell me the name or any details of this alternate insurance, and says I need to call back through the customer service number.
I call back through the customer service number. The first person can't help me because my plan is a special little snowflake, so he has to transfer me to someone else.
The next person ends up being pretty helpful. She finds the name of the alternate insurance: Regence. I explain that this is the insurance Iwas on, until December 31st. She fixes that, and then I'm put on hold while she calls the pharmacy department to fix it with them.
After quite awhile, she comes back to let me know that they're having an issue, and then I'm on hold again. Then she comes back to say that there's some glitch with the system, and it may take awhile to straighten out.
She says that in the meantime, I can get a refill through a Group Health pharmacy while they sort it out. I tell her which one I'm closest to, she gives me their address and phone number and then forwards my call to them.
After waiting on hold for awhile, I tell the pharmacy person the whole story and my info, at which point she tells me I have to talk with the specialty pharmacy.
After another hold, I talk with the specialty pharmacy. After giving them all my info, she looks it up, says that yes, I should be covered at Bartells, and in the meantime she'll arrange for me to pick up a refill at the Group Health pharmacy tomorrow.
And that she'll do all that, and then call me back.
I eventually got called back, there were three more issues:
- I needed to get information from drug manufacturer to reduce co-pay.
- They could do a one-time refill, but I need to get prior authorization next refill.
- I couldn't use Bartell for that drug after all, I have to use Group Health's specialty pharmacy.
Now, supposedly, I'll be able to pick up the refill from the pharmacy tomorrow. In future, I have the option of either getting it shipped to me, or picking up from the pharmacy. But the Group Health pharmacy is only open from 8:30 AM to 6:00 PM, Monday through Friday.
Seriously, they're only open during the day during the week.
After all of this, I'm pissed at Group Health, and a little ticked at my employer for switching to a worse plan, but mostly?
Mostly, I'm pissed that America has such a backwards health care system and industry. "Spend More For Worse Results" should be our national motto.