Government health insurance > private insurance companies

by Caleb Reading

There, I said it.

I’m a pharmacy tech. I have plenty of complaints about medicare and medicaid, but they still underpay claims by a smaller margin than the insurance companies do.

And they keep us on hold for less time.

And the customer reps speak English.

And they don’t keep us on hold for 45 minutes then say, “You have to call this number instead, even though you dialed the correct number listed on the back of the insurance card.” Then you call the second number, wait on hold another 45 minutes, with Aaron Neville music playing the entire time, before a computer recording cuts in to say, “Our offices are now closed. Our business hours are . . .”

If you think your insurance company gives you bad customer service, take a wild guess how they treat the drug stores that aren’t even their customers. And if we tell you not to use that insurance because they’re jerks, we can be shut down by the feds for “price fixing.” Guess which group of lobbyists got that put on the books?

And medicaid’s a little less likely to pretend like they know what the patient needs better than a doctor would.

And they don’t charge us $4 just to submit a claim for processing and another $2 to reverse the claim (costing us $6 for a script that we never filled or got paid anything for).

And they don’t threaten to withhold $80,000 worth of claims because we sold a desperate, uninsured patient a prescription for 58 cents less than the insurance company paid for it. Because it’s a contract violation to sell even one prescription to a patient for even one penny less than the insurance company would pay, but charging the cash patients three times more is . . . okay?

And at least medicaid has one-time override codes so you can fill a non-preferred antibiotic for an infant on Saturday morning instead of trying to get a prior authorization maybe by next Wednesday if you’re lucky and you sacrifice enough chickens to Baron Samedi.