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Teacher Health Insurance: A Bitter Pill

There’s an old joke – um… two elderly women are at a Catskill mountain resort, and one of ‘em says, ‘Boy, the food at this place is really terrible.’ The other one says, ‘Yeah, I know; and such small portions.’”  Woody Allen, Annie Hall

Imagine a friend badgered you into going to lunch at a popular but expensive restaurant. Each entree is a clashing combination of ingredients you would never consider combining, and the final results are an assault on your southern taste buds. However, you are very hungry and know this will be your last chance to eat today.

You go over the menu, hoping to find something that won’t make you wretch while simultaneously emptying your wallet. You can order a less expensive but skimpy meal that won’t put the slightest dent in your hunger or take out a mortgage for something more substantial. You find little value in either proposition, so in utter futility, you order the same bad meal you had the last time someone dragged you to this place. You know it is a lame choice, but at least it is familiar.

I made my annual insurance benefit selections yesterday, and unlike every other year, I did not wait until the last day to do it. After staring at the same unappealing menu year after year, I decided I might as well make it easy on myself and go with the status quo.

Since I am on several medications, including two that are very expensive, the most critical part of my health coverage is the prescription drug benefit. This benefit has also proven to be one of my greatest aggravations. An encounter from 2012 illustrates why.

When I got my last prescription from Medco (the mail-order giant supposed to save us money), I found they sent me 19 days of one of my medications instead of the usual 90. So I called them today and got the familiar computer voice asking me all kinds of questions I know will be asked again once an actual human gets on the line.

Human #1 – I give him my prescription number, answer questions about my name and date of birth again, and explain the problem. He asks if he can put me on a 1-2 minute hold while looking into the system. After 2 minutes, he tells me that my plan has a “dedicated team” that handles our customer service and asks me if I will hold for 1-2 minutes again.

Human #2 comes on the line 3 or 4 minutes later and asks me the same questions I have already answered twice. She then asked me if I would hold for 1-2 minutes while she looked into my account. Four minutes later, she returned to the call and told me that she couldn’t help me because my plan had a “dedicated team” to provide customer service.

I told her that’s why I was transferred to her. She informs me that I was sent to her by mistake and that if I held for 1-2 minutes, she would transfer me to that “dedicated team.”

Human #3 comes on the line in about 4 minutes and tells me she is trying to transfer me to the dedicated team and asks if I would hold for 1-2 more minutes. She returns and tells me that her system won’t let her redirect my call to the correct office, so I need to call another company called Caremark. She then gives me an 800 number to reach Caremark.

I asked why I needed to call another company when Medco filled the prescription wrong. She paused and then asked me if I would hold for 1-2 minutes. I laughed and hung up.

I call Caremark, and the computer voice menu tells me I have reached customer service for my Aetna health insurance. 

 . . . Sigh . . .

My insurance is from Blue Cross Blue Shield. As I hang up the phone, I wonder what Blue Cross offers in the way of mental health coverage.

Tagged healthinsuranceMedicineteaching