Did I just employ the “Treat Them Like You are A Kindergarten Teacher Again” method with my insurance company today? I surely did. Did it work? Probably better than intended because I made an actual doctor feel contrite.
So, my insurance has been trying to not cover my SNRI because it is new on the market and no generic available yet, so pricey.
I apply for a refill and the request gets locked for review. Again. For the 3rd time.
This time I call and immediately ask to speak to the actual doctor making these clinical decisions. Very politely. Must be a slow day because they allow it.
ME: [Teacher voice] I’m calling in regards to the SNRI you have placed a lock on. Why was this decision made?
DOC: Well, there are dozens of other medications on the market in that tier, and far cheaper for you and [insurer]. We have sent a request to your doctor to consider alternatives.
ME: I am aware of that. So, can you do me a HUGE favor and look up my prescription history really quickly and tell me how many SSRIs and SNRIs were only filled once in 2022 for me, showing they were poorly tolerated?
DOC: It looks like eight.
ME: Great job! Now, can you please look at my genetic test for psychiatric drug tolerance and tell me how many medications are listed in the safe category?
DOC: Two.
ME: Awesome! Now, can you tell me what type that other drug is that I’m not taking?
DOC: Yeah, totally, it’s an MAOI.
ME: That’s correct, you’re really knowledgeable! Should I be taking something as dangerous as an MAOI with my other medications, or even just in general?
DOC: It’s contraindicated for sure.
ME: It is! So true! So, last question since you’ve been incredibly smart and helpful. Is it less expensive for [insurer] to pay out for the medication knowing they already get a huge manufacturer discount anyway, or is it more expensive for them to pay for me to need potentially long-term inpatient psychiatric care?
DOC: I’ll clear the code, ma'am and flag it as medically necessary. I’m sorry about this.
ME: I appreciate you SO MUCH. You have a great day now.
WALGREENS PHARMACY TECH WITH 5 NOSE RINGS AND PURPLE HAIR STARING AT ME: ……….. OKAY! It’ll be ready in five minutes. You wanna come work here?
When it’s “put your baby down and get back to work” vs. “let your baby keep cuddling you as much as he needs”… I think it’s obvious what I would choose to do.
I suppose it’s high time I share this on my main blog…
After 9+ long months and plenty of sweat blood and tears, with the support of 3 Japanese nurses, my legacy emerged into the world, at 3.1kg, screaming and flailing.
So far there have been no major complications and I’m recovering well, while the little spawn is gaining weight and power.
I realize not everyone has seen their father chuck a smithing hammer at a person standing some distance away, hitting a doorframe right next to said person’s head, and when the shocked person went- “You could have hit me!” The answer that came was- “say that again and the next one will.”
I just got a beautiful comment on one of my fics and the urge to print it, frame it, and hang it on my wall like an artpiece is very strong. Maybe I’m overreacting?
But like … Does the universe have to test me with cat puke first thing when I resume consciousness? And right on top of my duvet. While I’m using it, mind you.
I want a refund for today and it isn’t even an hour into being awake.
