Saturday, November 10, 2007

This week.....

has just basically sucked, for the most part. The kids were really off this week. I'm still not sure why, but REALLY off. I'm really not feeling well... my thyroid needs to be checked, BIG time. I am feeling the fatigue, and the lack of ability to physically do stuff, which makes rehearsals (and learning lines!) tough. I'm doing fairly well learning my lines, but there are two scenes that are real bears and that's driving me nuts!

EVERY DAY (except Friday), there have been HUGE accidents-- and not just one or two, but a LOT of them. On Thursday, it took me over TWO HOURS to get to work. And I've been asked to do several extra things for work, as well, which I really don't mind doing, but right now I don't feel like I have the time. It's really hard to coordinate having everything I need where and when I need it for work, which is yet another stress, and I'm finding it hard to get up in the mornings (yet another reason for me to know that I need my thyroid checked, IMMEDIATELY). And I'm just feeling in general, depressed about everything that's going on and am afraid to look at my 401(k) right now.

And on Wednesday, I'm up in my room teaching and one of the guys comes up and says, "You'd better check your car. You have a flat tire!" Well, it wasn't quite flat, but it was getting there fast. And it was fine (to the eye) that morning, although I had noticed a little vibration and pulling when I braked the night before, so it was a slow leak, apparently. Called AAA, and they tell me that my membership has expired, and they didn't get my check for the renewal BACK IN AUGUST. ::SIGH:: NOW, you tell me? Anyway, I had to pay by credit card (they were really nice about it), and now I'll have to try to find the check (which won't be easy since the bank doesn't return cancelled checks anymore).... anyway, the guy who came out was very nice. He put air in it, and I put some more in a bit later, and then went to get it fixed. Cost me $25 and 2 hours of time!!!!

We got our info for our benefits enrollment for next year. I was HOPING that it would be better. It's not. The medical coverage is not a problem (although it's expensive, when I hear what other people are paying for theirs, I feel lucky). It's the Rx that I can't stand. They changed two years ago to a particular company, which was then 'taken over' (I guess) by Caremark. I HATE Caremark. I hate them with a passion. The first thing they did was IN THE MIDDLE OF THE YEAR, the increased our co-pay. When called to ask why, the only answer I got from them was, "We're not your insurance company, we're just an administrative company." Yet, EVERY SINGLE COMMUNICATION avenue goes to them, so you can't actually TALK to anyone at the insurance company... but Caremark won't give you any answers. They tried to push a generic thyroid med on me. Now, that would actually sorta be ok, except for the fact that the generic is NOT 'bioequivalent' as they tried to tell me. Their definition of 'bioequivalen' is a TWELVE PERCENT difference in effectiveness. In this case, stronger. Now, for some medications that might not be a problem. For thyroid, it's enough to land you in the hospital. Not to mention that you don't necessarily get the SAME generic each time, and each one is a different strength, so you can never regulate it... and thyroid hormone has a very small margin for error. THEN they sent a notice that they were not going to cover another med AT ALL. So, for two years, every time I go to pick it up, I get, "Don't you have insurance?" And have to explain the whole thing to them-- and then this SAME insurance company that won't COVER it has the NERVE to tell the pharmacy that they won't permit a refill because it's too soon! TWICE. Morons. If I could have, I'd've stopped paying the premiums, because it was simply costing me more money-- they weren't paying for anything... but it's part of the package with the medical coverage, all the same premium.

Anyway, so now we're going to have Rx coverage through BC/BS. Okay, fine. Except that EVERY SINGLE brand medication I looked at (and I looked at a lot, just to see), is what they call a "Tier 3" -- with a very few exceptions that are "Tier 2." "Tier 1" are all the generic ones.

Which means, you pay a co-pay (relatively small one) for a Tier 1 med. A $25 copay for a Tier 2 (a 'preferred brand" med) and for a 'nonpreferred' one (Tier 3), you pay FORTY FIVE dollars, PLUS the difference in cost between the generic and brand, up to the cost of the script. Which means, again, I'll be paying premiums and getting nothing in return. Oh, it just INFURIATES me how they can take advantage of people. And how we spend SO MUCH on health care costs, and get relatively little for it, in comparison to other countries. We have one of the most expensive health care systems in the WORLD, and yet we are FORTY FIRST in life expectancy among the industrialised nations.

5 comments:

KentuckyGal said...

Insurance sucks, doesn't it? *sigh* What play are you doing?

Actorgirl said...

It surely does! I guess the only thing worse would be NOT having it. ::SIGH::

The play I'm doing is "The Best Christmas Pageant Ever." From one of my favourite children's books! :)

Sean said...

Please do your research before you start bad-mouthing certain corporations. Caremark is an ADMINISTRATOR of the plan that is created by YOUR insurance company or employer; CAREMARK does not increase your co-pays. They follow the contract created by YOUR insurance co. or employer.

Secondly,
3-tier drugs are very expensive for your plan and 99% of 3-tier medications either have a generic or similiar, less-expensive brand name medication...so stop bitching about a $45 co-pay for a drug that your plan is paying hundreds or thousands of dollars for becuase you're unwilling to use the generic or a less expensive brand.

Dawn said...

Just read your message & have to say that I can relate. Our insurance was switched when we moved and we are now stuck with 'Caremark'. We've had nothing but trouble with them. They've frustrated us and our doctors. You can read stories from other consumers here concerning them:

http://www.consumeraffairs.com/rx/caremark.html

I hope your health improves very soon.

Happy New Year! :-)

Regards,
Dawn

Actorgirl said...

Thanks for this information, Dawn... what I read there was shocking and very sad, but not surprising. I would NEVER have sent a $x into them for mail delivery, even thought it cost more to get it at the local pharmacy. Let's hope BC is at least better in those regards!

I totally understand the frustration in those stories... I got the same runaround. :*(