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I’m thankful to have health insurance, but some policies confuse me.

My employer switched insurance companies this year. Overall, I’m happy with them. I’m allowed to choose which health system I wish to use, which means I’m able to keep a doctor I adore. My doctor’s office is about 10 minutes from my house and conveniently located on my way to work for those appointments that can’t be scheduled for my day off.

I really don’t understand why health insurance has to be so complicated, though. I have been taking a certain medication for the past eight years. It comes in one size, which lasts me three months. I have a friend who uses the exact same medication, but his prescription is monthly. Our co-pays are different due to how long the medicine lasts us.

My three-month supply of this medication has always been available at my pharmacy. My co-pay is $100, which is the same amount I’ve paid for the past couple of years. I have never ordered my prescriptions by mail. My new insurance company is insisting that I order this prescription through their mail order service instead of picking it up at my local pharmacy.  Yet my friend can go and purchase the exact same box from the pharmacy because he uses the entire box in a month. His co-pay is $40.00. It baffles me. I appreciate the fact that my co-pay averages $33.33 per month, but I just don’t understand why it must be ordered through the mail. Since my medicine must be refrigerated, it seems more logical to have me go to my pharmacy to obtain it. The company who ships it to me will have to pack it with some sort of coolant like dry ice, or the drug will spoil. It’s nothing for the heat index to reach 110 degrees here in the summertime. I don’t know how long dry ice lasts, but everything melts in that kind of heat.

I’ve made an appointment with my doctor to discuss my options. I will be taking a printout from my insurance company that indicates which medications are approved and under which tier each of them falls. Unfortunately, she isn’t able to see me until April 18th. Her office gave a paper prescription to use for my first mail order. I am hopeful that we can find an alternative, which may be purchased from my pharmacy along with the rest of my medicine.

I’m thankful to work for an employer that offers good insurance. My doctor visit co-pay and most of my drug co-pays are reasonable. My premiums are not outrageous, so I really can’t complain there, either. I just wish our insurance was more logical.

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