I'm PISSED!!..need a little help from the smart folks here...

[haele]

30. You need to talk to your HR rep about that.

Your HR should have an EAP rep to deal with the insurance company, and maybe get you a NP Ombudsman to work with meds and appointments, especially since there is a chronic, life-threatening health issue involved.
We had a similar issue this year when my employer took a different AETNA package to save money; my spouse is permanently disabled and has psych issues and diabetes as well as arthritis; we were suddenly hit all sorts of crap with the mail-order pharmacy that was now a different company (Accredo/Medco) than the regular prescription pharmacy (Express-Scripts) even though everything was being paid through Express-Scripts, so we were always having pre-authorization issues (every month the doctor had to send the letter for one of the cheapest medicines).
And (get this!) after we hit our PPO family deductible of $3K (which we reached in early April), all prescriptions through Express-Scripts were now $5.00 or 10% for patent/name medications every month, but the 3-month mail order prescriptions had a deductible of $9K and we still would be required to pay the 1/3 retail price for the medication - so his three normally mail-order meds would be $1200/$873/$425 for 3 months of meds and required pre-authorization every time we need to refill, but $25/$5/$5 each month if we ran the prescription through Walgreens.
The Aetna NP that my HR requested (per the free wellness plan package) is in contact with my spouse every other week, and has gotten the pre-authorization requirements waived for the Express-Scripts prescriptions, but she wasn't able to do anything about the 3-month mail-order. She advised us to dump the mail order and just walk in; the price difference alone - even paying for the gas every month to pick up his prescriptions - was enough to get us to agree with her advice.

She was also able to get my spouse some realistic alternatives for diet and exercise that he could do in his condition and is helping us get through the process of having Aetna pay for getting him a wheelchair and other non-prescription medical devices to ease some of his issues and help cut down on long-term costs as part of the wellness program.

For-Profit Medical Insurance - they really don't want to make it easy for someone who isn't already healthy to get health care, do they? But they do love our premiums.

Haele