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So, I'm in Florida. Hotel has net access, which is nice.
Sorry about the huge multiple blogthings post a couple entries back. I could have sworn I put it in an LJ-cut. Didn't mean to take up your whole Friends Page. Oh well. Too late now.
Anyway, for those keeping track...
Aetna representative told me this morning that with my plan, pharmacy claims are processed as medical claims. (I knew that.) What that meant with BCBS was that they accepted claims normally, but would apply them to my deductible. I'd get a discount at the pharmacy because BCBS negotiated cheaper prices for members, and all the claims stuff would be handled automatically.
What it means with Aetna is that I have to pay for everything at the pharmacy up front, then mail them the reciepts. With a medical (not pharmacy) claim form attached. And probably watch as the claims dept comes up with one problem after another. "Why are you sending this here? This is a pharmacy claim." "That's how I'm supposed to do things with my plan." "Oh, right. Well, why didn't you fill out all this stuff on the bottom half of the form?" "Because it's a pharmacy claim, and the form was designed for office visits." "Oh, right. Well, why are you sending a pharmacy claim with a medical form?" (And so on.) At least, that's how I imagine it'll go.
Adding to the fun is the fact that Aetna, unlike BCBS, only covers one month's supply at a time. I got three months' worth, because that's what I'm used to getting and because when it comes to something as critical as insulin, having a few spares is generally a good thing.
The rep told me to include a letter with the claim form, explaining the situation, and hope for the best. So, that's what I did. Mailed it all off on the way to the airport. We'll see how it goes.
I'll have to remember to look into getting stuff from Aetna's mail-order pharmacy. I have a feeling that'll save a lot of hassle (and postage) in the future.
Meantime, I'm going to try not to worry about the money. They'll do what they'll do in their own time. Getting used to the ins and outs of a new insurance company will take time. The important thing is that the same stuff is covered (in different quantities, perhaps), and that my total expenses for the year should come out to about $2500 less. Even if they didn't negotiate any deals with the pharmacy, that just means I'll reach my deductible and max out-of-pocket limits faster.
Otherwise, it was a reasonably good day. Most of it was in transit, actually. Funny how we spend longer getting to the airport, going through security, waiting at the gate, etc than we do in flight. The airport is about 50 miles away. Florida is about 1000. Yet it takes 2 1/2 hours to fly down here (including waiting for takeoff clearance at a NY-area airport) and we had to leave home 3 hours before boarding time.
Flight was fine. Except for the boisterous people in the row behind us (all three were talking rather loudly, and the guy behind me kept digging around in the pocket in front of him, which amounted to kicking the back of my seat) and the quintessential screaming baby (thankfully ten rows back).
Had a nice dinner out with Mom and Dad, and now I've got the evening to myself. I'm sure you're thrilled and fascinated. (I have got to figure out a way to get better material here. Preferably without inventing an entirely fictitious life. Because, really, that'd be way too much work.)
Sorry about the huge multiple blogthings post a couple entries back. I could have sworn I put it in an LJ-cut. Didn't mean to take up your whole Friends Page. Oh well. Too late now.
Anyway, for those keeping track...
Aetna representative told me this morning that with my plan, pharmacy claims are processed as medical claims. (I knew that.) What that meant with BCBS was that they accepted claims normally, but would apply them to my deductible. I'd get a discount at the pharmacy because BCBS negotiated cheaper prices for members, and all the claims stuff would be handled automatically.
What it means with Aetna is that I have to pay for everything at the pharmacy up front, then mail them the reciepts. With a medical (not pharmacy) claim form attached. And probably watch as the claims dept comes up with one problem after another. "Why are you sending this here? This is a pharmacy claim." "That's how I'm supposed to do things with my plan." "Oh, right. Well, why didn't you fill out all this stuff on the bottom half of the form?" "Because it's a pharmacy claim, and the form was designed for office visits." "Oh, right. Well, why are you sending a pharmacy claim with a medical form?" (And so on.) At least, that's how I imagine it'll go.
Adding to the fun is the fact that Aetna, unlike BCBS, only covers one month's supply at a time. I got three months' worth, because that's what I'm used to getting and because when it comes to something as critical as insulin, having a few spares is generally a good thing.
The rep told me to include a letter with the claim form, explaining the situation, and hope for the best. So, that's what I did. Mailed it all off on the way to the airport. We'll see how it goes.
I'll have to remember to look into getting stuff from Aetna's mail-order pharmacy. I have a feeling that'll save a lot of hassle (and postage) in the future.
Meantime, I'm going to try not to worry about the money. They'll do what they'll do in their own time. Getting used to the ins and outs of a new insurance company will take time. The important thing is that the same stuff is covered (in different quantities, perhaps), and that my total expenses for the year should come out to about $2500 less. Even if they didn't negotiate any deals with the pharmacy, that just means I'll reach my deductible and max out-of-pocket limits faster.
Otherwise, it was a reasonably good day. Most of it was in transit, actually. Funny how we spend longer getting to the airport, going through security, waiting at the gate, etc than we do in flight. The airport is about 50 miles away. Florida is about 1000. Yet it takes 2 1/2 hours to fly down here (including waiting for takeoff clearance at a NY-area airport) and we had to leave home 3 hours before boarding time.
Flight was fine. Except for the boisterous people in the row behind us (all three were talking rather loudly, and the guy behind me kept digging around in the pocket in front of him, which amounted to kicking the back of my seat) and the quintessential screaming baby (thankfully ten rows back).
Had a nice dinner out with Mom and Dad, and now I've got the evening to myself. I'm sure you're thrilled and fascinated. (I have got to figure out a way to get better material here. Preferably without inventing an entirely fictitious life. Because, really, that'd be way too much work.)
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And a fictitious life, while time-consuming and possibly quite complicated (take that Clark Kent guy, for example), could be quite fun. ;)