“Yes Miss Hall, we received the request for the prescription from your local pharmacy but have been unable to process the request at this time.”
“What? Why?”
“When they faxed it over, they failed to include any insurance information. All they sent was the prescription along with the patient’s name and date of birth. Do you have a few moments to create a patient profile so we can process the request?”
Kelly sighed. Could her day get any better? “Yes, that’ll be fine.”
Kelly grabbed her purse and removed her insurance cards as the woman from the pharmacy quizzed her over her insurance details.
“Do you know how much it will cost?” Kelly asked when they were finished creating Emma’s profile.
“Let me run your benefits and I can tell you,” the woman said as she clicked around on her computer screen. “Okay Ms. Hall, it looks like, with your insurance, a 90 day supply will cost $242.”
“And that’s with my insurance?!”
“Yes, that’s after your insurance. Now once you meet your annual deductible, the price will go down considerably—to about $124 every 90 days.”
“Do you know how close I am to meeting my deductible?”
“No, we’re unable to see those details, but you can call your insurance company and they should be able to tell you.”
“I’ll do that, and can you let me know when you’ll fill this medication?”
“We’ll get this filled as soon as possible. You should receive it within the next 14 days.”
“Fourteen days?” Kelly asked in disbelief. “But she needs this medicine. Can I pay extra for expedited shipping?”
“We can expedite it, but it will only arrive about 5-7 days sooner. Would you like me to do that for you?”
“Yes, please do. Thank you.” Kelly said as she hung up the phone.
Oh, these phone calls, she thought, will never stop. She flipped over her insurance card to call the toll-free number on the back to learn more about her deductible. Since they were generally healthy, she hardly used her insurance before. This was unchartered territory for her. As the prompts continued to ask what seemed like a million questions, Kelly’s frustration began to grow. After several minutes of prompts, she was finally listening to the tacky elevator music that intermittently cut out while holding for the next available operator to answer her call.
After her long hold time, she found herself scribbling a ton of notes about her insurance onto a sheet of paper as she fervently questioned the man on the other line. He patiently explained her deductible, including the current and pending charges from the labs and doctor’s appointments. He then estimated how much of her deductible she still had to meet prior to when the insurance would begin more coverage. When signing up for health insurance, she opted for the lowest priced monthly plan since her and Emma lived on a tight budget. She would soon regret making that choice; her deductible was $6,500. To date, she’d met about $450; leaving her to still meet over $6,000 of the deductible until they began to increase their portion of coverage. She also learned it meant she had approximately $450 worth of pending medical bills on their way—and they hadn’t even seen the specialist or began any real testing yet.
Exhausted from the day’s events, Kelly curled up into bed with Emma and fell fast asleep. She would let herself worry about how she was going to pay for everything later. Right now she had to get some rest. She’d been running herself ragged taking care of Emma, going to doctor’s appointments and calling everyone all over God’s green Earth trying to figure things out. She had to get back to work. Brian had given her a total of eight points for taking off while her daughter was sick; it only left two points until she’d lose her job. With bills to pay and food
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