medco/GHI rant

This is what I sent to Medco recently in response to their survey.

After receiving info today from GHI, yet again, telling me never to stop taking my anti-depressants without first talking to my doctor, reminding me that it may take 6 months to see results, I am so angry that the combination of GHI/Medco has made it virtually impossible to get my anti-depressants on time, regardless of when I put the order in.

I order my anti-depressants quarterly for a 3-month supply as required. The last two times, I have had significant problems.

Here’s what happened with my anti-depressant, Cymbalta:

On Feb 3, 2009, I received a note from Medco dated 1-26-09 saying that I did not have the authorizations I needed. I’d already had the order in for two weeks and was shocked. I spoke to Larry at GHI who said all the authorizations were fine and Medco should be shipping any day.

On Friday Feb 6, 2009, I checked online and saw that my Cymbalta order was no longer there. I spoke with Liza, a customer service rep from Medco who is obviously paid to say no. She said orders don’t disappear, mine did. I believe it timed out in the system. She was absolutely no help and I ended up screaming at her because I know how important it is that I don’t miss my meds. I finally insisted on speaking with a supervisor and spoke with Akisha who was understanding, did not assume I was lying, checked out everything and set it up so that my Rx was delivered the following Tues at no cost to me. That’s all I wanted.

On May 11, 2009, I had to go through the same thing again. I spoke to Akisha at GHI who said she would call Medco with the authorization and get back to me. I never heard back, so I called again and spoke to Raymond who told me that he would be the person to put through an expedited order and had nothing for me. He not only put through my order, but also got me a 7-day supply from my local pharmacy so I wouldn’t miss even one dose. He was fantastic!

When GHI moved to Medco:

My birth control pills did not get transferred, and I didn’t find out about it until it was almost too late. I’m not supposed to miss doses of birth control pills.

I received only a 30-day supply for Allegra-D, which Express Scripts says is a “maintenance drug” and can be dispensed in 90-day increments. I had to call to find out Medco does not classify it as a maintenance drug, so I have to order and pay $54.28/month.

I pay GHI $650/month for the privilege of paying $341.75 out-of-pocket for Cymbalta quarterly.

As a technology manager, I know that the problem is Medco and GHI’s systems don’t properly communicate. If I were the boss, I’d have to say, “then find a provider our system does speak with.” I can’t even get a price until my order arrives.

Honestly, I can’t wait to dump both GHI and Medco. Dealing with healthcare should not make me ill. Please do something to improve communications between GHI and Medco so others like me don’t have to suffer.

taxes done. back to how to pay the mortgage

I went to do my taxes the other day and I don't owe anything!! yay!! If I did, I honestly didn't know how I would pay for it. (my tax guy is fantastic! Mark Avrutine 212-826-5050, tell him Lisa sent you)

Instead of it putting me in a better mood, it just reminded me how much I spent last year when I thought I would make money again.

I'm starting to panic a little. I guess it's about time. Here's how I got here, in a nutshell:

• I stopped looking for consulting work after a particularly bad stint at an ad agency where no one but me wanted the project to succeed. It also brought up a bunch of old issues I'd never resolved dealing with difficult people by doing everything they want, regardless if it's the right thing to do.
  
• Got a $100K home equity loan based on my retirement accounts on a UWS co-op valued at $550K with an outstanding mortgage of $60K. Basically, I'd paid off about $100K of my mortgage and I borrowed it back.
• I invested the home equity money and used it to pay my mortgage/expenses while I learned to be a figure model and bartered for painting lessons. Problem is, figure modeling only pays $15-20/hr. Bartering for painting works because we're both underpaid. (Karen Kaapke is my instructor. She's a genius with flesh tones.)
  
• I love modeling and it turns out I'm pretty good at it, thanks to the artists who have taught me: Jonathan Soard and Ariel Higgins in particular, along with Karen. My trainer Suzanne (917-691-2115, tell her I sent you) has been working with me for five years now and she gets credit for my stability, balance and tone.
  
• I'm basically healthy. I suffer from allergies and depression, both which require treatment. For the past few years, I have been paying $650/month for health insurance which gives me the privilege of paying for therapy sessions after 20 a year, half or more for prescriptions thru Medco (I'll get to my medco rant later, I promise), orthotics and pretty much anything else the insurance doesn't feel like paying for. Obviously, I can't afford these premiums any longer and it's looking like I'll end up spending less with a high deductible catastrophic plan and paying out of pocket for the rest.
  
• Visiting my psychiatrist to get a new Rx, I found out that he will charge me $100/15 min session that I'm required to have 4 times/yr, even though I only saw him once a year when I had insurance. Ugh! He even acted surprised when I said I pay my own insurance. Hello!! I live in the US where healthcare is a privilege, not a right.
  

I want everyone to know that not making money and healthcare are issues for all of us. I'm competing with every person who has been laid off for project work. Needless to say, the phone isn't ringing. I've also tried to start a home organizing business, but in this economy, no one wants to spend.

Usually, I'm a very optimistic in the face of opposition. But I have to admit, I'm concerned. I sold some land in Costa Rica before things fell completely apart. I never got around to investing the money, so at least I didn't loose any of it. That's what I've been living on and it's almost gone. I've gotten a bunch of modeling gigs lately, but it's almost embarassing how little that will help. I'm probably better off looking for organizing and other higher paying work instead.

I will continue to let you all know how ugly it gets and the issues I run into. I will also send positive energy to you because I believe that will help. Feel free to send it back. thanks for listening.