doctor's orders

The kids are finally loaded in the car and ready to go. There are very small segments of the day where no one is napping or eating that we can get errands run. I start the car and look at the clock. 1pm. I have exactly one hour before Lydia melts down because she is suddenly starving to death. That should be enough time to run to Target, a half mile from home, to get her prescription and a few other things, shouldn't it? For some reason, I am doubtful.

I pull into the Target parking lot, park near a cart return, load the kids into a cart, and find my way back to the pharmacy by 1:20. Forty minutes to go. The pharmacist, who has gotten to know us well over the last few months, had been kind enough to call me this morning to ask when I'd be by to pick up Lydia's medicine, so it should be ready for me, right? Nope. Check back in 20-30 minutes. I'm not surprised, but frustrated. Brett hates being contained in a shopping cart. I take my time selecting a few necessities, letting Brett play with them, even though it means picking them up off the floor over and over again. Back at the pharmacy counter at exactly 1:45. The prescription is handed to me a few minutes later. Lydia is winding up. Getting this prescription filled has been quite an ordeal, so I decide to check it before I leave. The label says, "Take 1 ml twice daily". Wrong dose. I'm screaming inside.

You see, for a month now, since Lydia's 4 month check-up where her doctor increased her dosage, I've been trying to get this prescription. Our insurance wanted a prior authorization before they would pay for it. According to the pharmacy, prior auths can take up to 14 days. Apparently it doesn't matter to the insurance company that Lydia needs her medicine every day and I'm only allowed to get a 30 day supply of the prescription filled exactly every 30 days. The pharmacist had gotten me a 14 day supply of the new dose by refilling an old prescription that would have been a 30 day supply. I had been calling the pharmacy every couple days to see if the prior auth had gone through, and finally was told it had, but I couldn't get it filled until April 29th. When I called to get it filled on the 29th (9 days after Lydia ran out of her rationed medicine), I was told the guy who told me it was authorized was wrong, and it hadn't been authorized. So, on the 30th, I spent an hour on the phone with our pharmacy, clinic, and insurance, trying to figure out who had dropped the ball. The clinic called me late in the day and told me everything had been cleared and I could get the prescription filled.

So, here we are, 10 minutes until Lydia blows, and I just paid yet another co-pay for a prescription dosage that had actually never been prescribed. I go to the counter, explain the situation AGAIN, and after a few minutes of scrambling, I am told they will have to talk to the prescribing doctor to verify the dosage and would I like to wait around for it...At this point Lydia is crying in my arms and Brett is grabbing and throwing anything in reach. The pharmacist did not need a response from me. He told me he'd call when it is straightened out.

At 2:05, we leave the store with a 30 day, but actually 15 day supply of medicine. Lydia is screaming. I'm getting looks of sympathy from onlookers. I load the kids back into the car and head home. While the pharmacy and clinic know us by name, our insurance knows us by claim number. I have learned that while my kids are my world, we're their only true advocates. And if I have to battle this hard for a $60 prescription to be covered, I dread the day all Brett's eye bills are assigned a claim number and cross the desk of a person who's job it is to save the insurance company money. Don't get me wrong - I am so thankful for our insurance - it just angers me when they pick and choose what they want to pay for, as if they know the best treatment for our children.

I didn't wait by the phone for the pharmacist to call me.