Arthur is the nice customer service rep at my insurance company who informed me, while Sam was wheezing in my other ear, that my retail limit has been reached and I am supposed to refill "maintenance medications" through the mail and not at retail stores...in order to "maximize benefits."
It just would have been nice if someone had told me...you know...in advance of the asthma attack.
Thankfully, Arthur completely understood that I work for county government and therefore relevant information isn't necessarily shared...and put through a one-time "exception"...that will be ready in 24 hours. Yeah...I know. But that's "the best they can do" and I just have to understand (as I watch my son turn blue).
All this to maximize benefits.
Breathing is a pretty significant benefit, don't you think?
And you know what maximized benefits mean? An inhaler...that costs $41...insurance covers $21 of it. I've refilled TWICE ALL YEAR. So I can certainly see where there might be significant savings by not allowing me to refill them at retail prices. I mean sheesh...I just might bankrupt the whole dang company!
I honestly contemplated saying, "I have two kids that don't breathe...they're really not as much fun as those that do...so I'd like to keep the breathing ones...you know...breathing."
I really should have.
**(Sam did not expire. The attack was soccer-induced and relatively minor...and because I love my control, I always have a backup inhaler.)**
Exception denied. They'll put it through to a higher decision-making authority and they may possibly grant it. So that's another 24 hours.
The online forms have been filled out. IF approved, the medication should SHIP in 10-14 DAYS.
Guess Sam is supposed to just hold his breath until then.