A Kreng Jai Challenge....

In getting ready for my surgical appointment on Monday, I had to get a few prescriptions. Nothing serious, just little things that will make it easier for the surgeon to poke my eyeball and do his magic.

I went into Target and found out that my Medicare card doesn't match my Blue Cross RX Gold card.

(sigh)

The plan I chose for my "Part D" coverage is the Blue Cross RX Gold plan which is supposed to guarantee me a co-pay of $3.10 on any and all prescriptions.

Here's the Cliff Notes of how that came to be. After this, I'll get to the point of this rambling.

Medicare notified Blue Cross that they (BC) will be responsible for my Part D coverage as I am a low-income recipient of benefits. The "Gold" part of the plan was of my choosing. I pay a small premium for the upgrade. It includes more drugs in the formulary than the basic plan and the co-pay is considerably lower. I didn't get to choose the insurance company (basically a third party administrator for Medicare ~ confused yet?) that would provide my coverage.

Somewhere between Medicare and Blue Cross, someone didn't update a database so I was not "in the system". (If I ever hear that phrase again, I'm going to vomit!) When the pharmacist went to submit my claim, it came back as my not having any Part D coverage. The pharmacist told me that I would have to pay cash for the antibiotic eyedrops because of this error. He told me to call Medicare.

I should have known! Get on the bus to Call Center Hell.

Medicare told me to call Blue Cross. Blue Cross told me to call Medicare. Medicare volleyed me back to Blue Cross ~ and on we go. I spent 5.5 hours Friday afternoon on the phone.

Finally I got a supervisor at Medicare who made a few phone calls to Blue Cross on her own. "After all, we have a bigger bat," she said.

Well... ermm... yeah. Okay. After 5.5 hours on the phone, she could have told me she had a hotline to Jesus Christ and I would have believed her.

As a result of her conversation with BC, the problem was to be fixed by 1.00 PM on Saturday. I was given a tracking number and supposedly "inside" phone number.

The "inside phone number" was just the Customer Service line and none of the representatives knew what to do with the Help Desk tracking number.

How hard can it be to update a freaking database? It's not that bloody complicated! It's one command on a command line after a search through the beneficiary archives!

Looking at yet another marathon of phone calls, I lost it.

Just plain lost it. My housemates heard me and came to find out what was wrong. I don't think they've ever heard me yell before.

While managing to make it clear to the representative that I was not angry at her but at the situation, I let loose with some invective that would have put Howard Stern to shame. I managed to avoid the f-bomb but make no claims beyond that.

I'm hardly proud of it. It wasn't funny or cute. It was hurtful and damaging to the woman on the other end of the phone who had to hear it. For that part, I am truly sorry. I am ashamed by my lack of self-control and make no excuses because there are none, particularly for one who gives plenty of lip-service to traditional Thai values.

What I am not sorry for is that if my conversations with more than twenty people will cause Blue Cross to take a look at what falls through the cracks and the larger implications, my frustration was worth it. If I had been someone who needed ~ say, heart medication or something else life-sustaining rather than just some stupid antibiotic eye drops, I could be dead this morning. If I'd been someone who required medication for a child, that child could be dead or seriously ill.

There is absolutely no excuse for these kinds of errors.

I ended up paying cash for the eye drops. What if I hadn't had the money?


Peace,


~Chani