I'm stuck in a Kafkaesque situation w/my insurance company (Anthem). I currently get infusions of a biologic for Crohn's. These are incredibly expensive as well as inconvenient. I'm lucky, in that my insurance company pays for almost all of this.
The same drug is now available in the form of a self-administered pen which is far less expensive and more convienient. However, that falls under the purview of CVS Caremark, who Anthem has designated as its pharmacy benefits manager. CVS Caremark is denying the pen, saying I have to try a whole host of other meds which do not work for me first.
I talked to Anthem yesterday, and they have no idea how to get this approved. Their best suggestion is that my doctor schedule a call with the CVS doctor to argue with them. My doctor is not motivated to do this, as I'm already getting a treatment that works for me.
So I'm stuck wasting hours every few weeks for an infusion that could be replaced by an injection I give myself. And the hilarious part is that the insurance company stands to benefit the most, as they would pay far less.
This is the kind of thing that, if we had actual socialized medicine, I might be able to appeal to a government official to fix. But how can you appeal corporate bureaucracy?
There are mushroom based gummies available in local smokeshops due to some loophole in the that this particular strain of shrooms is not explicitly illegal.
My gf just got into shrooms. She started getting them from her weed dealer. His shrooms were overpriced, and hit or miss quality. Then we ran into a girl with a shroom hat at a festival, and it turns out she's a great source. Selling shrooms is her primary source of income. She makes little vegan shroom "cookies" (which are more like fudge), and also sells raw shrooms. She's a licensed massage therapist, and seems to launder the income by charging you for a massage.
My girlfriend is a "camgirl", and this behavior reminds me of the behavior of the lower tier, more shady cam / phone-sex sites.
The bigger sites that take a large percentage of the customer's money (40-50% goes to the site, not the model) also protect the models from chargebacks. Sites that take a lower percentage do not. One site she worked for ("cam model directory") has a spreadsheet of customers who are known to issue chargebacks that the models have to monitor before taking payment.
The same drug is now available in the form of a self-administered pen which is far less expensive and more convienient. However, that falls under the purview of CVS Caremark, who Anthem has designated as its pharmacy benefits manager. CVS Caremark is denying the pen, saying I have to try a whole host of other meds which do not work for me first.
I talked to Anthem yesterday, and they have no idea how to get this approved. Their best suggestion is that my doctor schedule a call with the CVS doctor to argue with them. My doctor is not motivated to do this, as I'm already getting a treatment that works for me.
So I'm stuck wasting hours every few weeks for an infusion that could be replaced by an injection I give myself. And the hilarious part is that the insurance company stands to benefit the most, as they would pay far less.
This is the kind of thing that, if we had actual socialized medicine, I might be able to appeal to a government official to fix. But how can you appeal corporate bureaucracy?