One thing that is absolutely and unequivocally true about life in the modern world is that it is absurd. As I noted in earlier posts, I retired in September. As a result, I now have the Empire Silver Script prescription plan instead of the New York State Empire prescription coverage that I had when I was still gainfully employed by and working for New York State.
As you can imagine, I am still getting used to my new-fangled retirement prescription coverage and the bureaucratic wrinkles that go with it. Anyway, today I went to get refills of my medications for only the second time under the new prescription plan. I particularly needed to get a refill of my Advair which I paid $15 dollars for three months when I had Empire work prescription plan. I was told there would be no difference between getting the Advair on my new retirement plan than my old by the union and the retirement officer at work.
There turned out, however, to be a big difference between prescription plan before and prescription plan after. I didn't quite hear what I was being charged when I was at the pharmacy; masks and plexiglass make it even more difficult for me to hear than without them. When I got home, I was surprised and shocked to learn that I had paid $60 bucks for a one month's supply of the generic version of Advair, Fluticasone Propionate rather than the $10 dollars for three month's supply. I immediately called Empire Silver Script and asked why I was charged so much. Life as crisis management! I was told that my prescription plan didn't cover the generic version of Advair but that it did cover the non-generic Advair. By the way, and ironically so, both my past insurance and my present insurance cover the generic equivalent of Singulair. Apparently, consistency really is the hobgoblin of prescription insurance company minds. I need to learn that. Anyway, apparently now when I need to get prescriptions and when I need to get prescriptions refilled not only do I have to notify the doctors and pharmacists what prescriptions i need refilled, I also have to tell them that I need to get only medicines that are covered by my prescription insurance company. Isn't it wonderful how bureaucracies make living so much more complicated?
I don't, of course, know why the generic version of Advair isn't covered since one would logically assume that the generic version is likely to cost the insurance company much less money than the non-generic and very expensive Advair and approving the generic version would likely save the insurance company monies. But then, as I have learned, cost logic is not necessarily a characteristic of bureaucracies while cutting a deal with big pharmaceutical companies probably is and I strongly suspect that is why Advair is in the formulary and the generic version isn't.
At this point, of course, I cannot take the generic Advair back. So, I am out the extra money. And that is just not so wonderfully absurd on a retiree's "salary".
Postscript:
In trying to deal with this bureaucratic nightmare I have contacted the doctor, the pharmacy, the insurance company, and my New York State Assemblyperson. I asked the doctor to make sure I got a prescription for Advair because the generic the pharmacy gave me is not covered under my insurance formulary. I asked the pharmacy to take the generic back but they won't and apparently can't. The pharmacist told me they had to fill the prescription as a generic because of the way the doctor wrote it. The insurance company, on the other hand, told me the pharmacy could have given me Advair, which is covered by my insurance formulary and wondered why the pharmacy did not give me the Advair. They did not know why the cheaper generic version of Advair was not covered (As my NY State Assemblyman pointed out in a communication to me, the company that makes Advair undoubtedly cut a sweetheart deal with the insurance company and corporate pharmacies), noted that whether something is in the formulary or not was a decision the government, presumably Medicare or NY Civil Service, makes, and agreed to send me forms so that I could ask that I be charged the Advair price for the generic. At this point I can't imagine this will be the end of this Kafkaesque and Orwellian nightmare and the expenditure of my time, energy, and monies on something I would prefer not to expend it on.
Addendum:
So, I get a call from CVSCaremark (care, lol) today, you know the corporation that cut a sweetheart deal with NY state and the makers of Advair, asking if i wanted to request the insurance cover the generic version of Advair. Once again, the bureaucracy has royally fucked things up.
What did I actually request and what do I want? I want a refund of $55 dollars for the generic Advair since I would only have paid $5 bucks if i had got the Advair.
Now don't get me wrong, it would be nice and it would be rational (if keeping down the cost for the consumer is what we mean by rational) if the generic version was covered. I know, however, that that form rationality is not how corps work. They work to enrich themselves and fuck us, the folk who actually work for a living, over, again and again.
So, of course, and this is real corporate bureaucratic rationality, I end up being fucked again, cause I sure as hell don't want to spend my time dealing with corporate bureaucracies even if it means losing $55 bucks because I lose that in time and energy spent, peace of mind, and the phone bill in dealing with them for what seems like an eternity. My rational goal, you see, is never having to deal with these corporate elite skanks, slags, and fucks ever again in my life though that is, of course, an impossible and utopian ideal since almost everything is a bureaucracy these days and almost all of these bureaucrats worship at the trough of Mammon. And let's not forget where the real buck stops: these corporations and their political puppets have all the power and they have the ability to play the merry-go-round game while I have neither power nor the willingness to ride the absurd corporate bureaucratic merry-go-round. Fuck em and fuck CVS Caremark, the corporation that takes not only a pound of flesh from me but also from my local independent pharmacy. I will never, never set foot again in a CVS for the rest of the life that I have left.
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