“Hierarchy structured insurance company Aetna, cause organizations, and pharmacies to suffer in their lines of communication” -The Imperfect Org

2017, January 1st to be exact and I called the Walgreen’s pharmacy to check on my husband’s medication.  We had been trying to refill it since a week and a half ago.  After countless communication with my doctor’s office and pharmacy, I discovered that my insurance company, Aetna can no longer refill his medication (nor mine) at Walgreen’s.  We can now only use CVS to refill prescriptions or we must refill them through a mail order.

CVS is not an option, as it is miles away from my home.  Walgreen’s is less than a mile.  How long will we have to wait for the medication if we order through the mail? Will my husband’s health suffer or deteriorate in the meantime? Is it already possibly suffering since it has taken way longer than expected to receive his refill?

The most disturbing piece about this is that the doctor’s office and the pharmacy had no idea what was going on.  I am not faulting them at all.  Whom I fault is Aetna for not adequately updating or notifying the doctors’ offices, nurses, and pharmacist who had actual scripts in their office waiting to be refilled. After about the fifth time I called I finally spoke with a rep and pharmacist who called the insurance company and was notified of the refill changes.  The pharmacist was just as shocked as I was about the ordeal. The pharmacist even tried to get Aetna to approve a few pills for my husband, just to hold him through until we could obtain the new prescription from CVS. Aetna said this could not be allowed.

Yes, it was open enrollment at my place of employment in November, but none of the seminars that I attended from Human Resources department bothered to include in their webinars and seminars that the way in which we obtained our medications could possibly change. Perhaps they did not know. I have checked my insurance companies site and I do not see updates regarding this recent change. Because it is the holiday and Sunday, they are closed and I cannot communicate with them myself. Frustrating.

My husband and I, as well as my place of employment, doctors’ office, and the pharmacies that we choose to obtain our medications through are customers of the insurance company. Communication is very much owed to the pharmacies as it is the doctor’s offices.  Despite how large these insurance companies are, and no matter how far up the corporate ladder or how deep the political affiliations; the people down on the lower frontlines should know how their jobs are being impacted by any updates to policy.  To bother not to communicate with all necessary parties is to leave many, as in our case, perplexed and inconvenienced.

And what’s up with the monopoly on prescriptions?  What sort of partnership or deal has CVS made with Aetna? Is it cheaper for the insurance companies? If so, what about the possible inconvenience to the person that needs the medication.  Some do not have a CVS nearby and not to insult the postal service, but some of us cannot trust our “friendly” mailman or mail woman or our neighbors for that matter.

So, note to you and to my future self, after open enrollment or updates to your insurance please make sure that you are not being limited or directed only to one particular pharmacy.  To not know this, is to potentially risk the health of you or your dear loved one due to poor lines of communication.

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Author: theimperfectorg

“Joi Su”, has been diligently working to help bridge the gap between what people expect in any organization and what they receive. Joi Su has earned a Master’s degree in Organization Development and a Bachelors in Psychology with an emphasis on Applied Behavioral Analysis.

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