Thursday, November 06, 2008


I HATE the medical community!! It's no wonder it's in such a mess. I honestly think that computer programmers set up these computer programs for them, and the people who work with the computers can't even think outside of what the computer says.

OK, as I've posted before, Medica will only cover 60% of Lukas' seizure medication because there's a generic available. So rather than pay the $151 a month, I've decided to give in and go with the generic, which is $56 a month. But I want to wean him off the Lamictal and gradually get him on the generic. But in order to do that, I have to have both drugs. Well, their computer says you can't get medications ahead of time. Last month when I called Medica about it, the woman suggested trying the vacation option (which was denied by the pharmacy's computer). So last week I called again and asked how do I get this done. They said to have the doctor fill out a form and fax it to their pharmacy department. Called our pharmacy earlier this week to have them run it through to see if it got done, and no it was denied. So I called the doctor's office, and yes, they had faxed it, and they would re-fax it. So I called Medica and spent 45 min. (mostly on hold) trying to get it through this guy's head what I was trying to do. Told him I'd called Medica last month about getting the meds filled early, and was told to try the vacation option (he said there was no such thing). After about 15 min. trying to explain what was going on, and he wasn't getting it, I asked to speak to a supervisor. After about 10 min. on hold, he came back on and asked me to spell Lamictal, they couldn't find it on their computer. So on hold another 10 min. and back to him asking if I got a letter telling about switching over to generic. No, I didn't, and told him 3 months ago the pharmacy sent home the generic, and because there's been so many problems with breakthrough seizures with the generics, I returned it and got the Lamictal, and the next month was when the price shot up. Explained about me calling about trying to get the generic filled early so I could wean Lukas off the Lamictal and onto the generic. So back on hold for 10 min., then he came back on explaining about the formulary exception, and how I could have the doctor fill that out. Tried explaining again that I didn't want that (at this point all I want to do is try to get him on the generic. If he has problems with it, there will be no problems getting him back on the Lamictal. If he doesn't have any problems, maybe next year I'll talk to the doctor about trying to take him off the drug completely.)

So anyway, back on hold. Then he's back telling me I have to have a script from the doctor to switch over to the generic, and me telling him, well I didn't have a script from the doctor when the pharmacy switched him over to the generic. And he's explaining how the pharmacy calls the doctor and asks if it's OK to switch to generic, etc. That's when I lost it. I told him it was going over his head, and I needed to speak with a supervisor. Back on hold. Then the supervisor came on. I told her I wanted to get a month's supply of Lamictal and a month's supply of generic, and the next month I wouldn't buy any! She got it!! She asked so you'd give him the Lamictal in the morning and the generic at night? Yes!! So she said she see how they could work that, and would call back today or tomorrow.

There is something so WRONG with this system!