Hey, Humana, are you on drugs?
I’m convinced that somewhere, some executive at the health insurance company Humana is on hallucinogenic drugs. That’s the only possible explanation for the absurd behavior of this company, as I’m about to describe.
For reasons far too tedious to go into, I changed the pharmaceutical portion of my insurance to Humana this year, starting February 1. As a man in my sixties with multiple prescriptions, I count quite a bit on that insurance — but I’d checked ahead of switching that it covered all of my maintenance medications. That turned out to be wrong.
Humana through the looking glass
Here’s what happened, in exactly the order that it happened. If this were a movie plot, you’d have to reject it for not being believable.
- 3 February: I tell my pharmacy, CVS, to renew several of my maintenance prescriptions.
- 5 February: Humana rejects prescription for one medication, which I’ll call TM. I take TM to manage a common condition among seniors. While there are other similar medications, over the course the last few years, my doctor has determined that TM is better at managing my condition.
- 10 February: My doctor’s office applies for and receives the prior authorization for TM. They promise me this medication is no longer a problem, but I am only authorized for 30 days at a time. (God forbid I start stockpiling maintenance medications.)
- 1 March: I request a refill of TM. Humana rejects it, despite the prior authorization.
- 1 March: CVS informs me that they can refill the prescription for about $30 for 90 days without using insurance, using some sort of “coupon” that they have. This is actually cheaper than what the insurance was charging. They refill the prescription. According to the paperwork that comes with the medication, the normal “retail price” would be about $450.
- 4 March, 9am: Text message from Humana: “Hi JOSHUA. This is a reminder from Humana regarding your medication. We will be calling you soon from 8777937878. You can also reach us at the same number. Text STOP to end messages. Text HELP for help.” OK, so you’re texting me to warn me that you’ll be calling me?
- 4 March, 11am. Humana calls to remind me to refill TM. I tell them it’s already been refilled and cheaper than using their insurance, and besides that they rejected it. The Humana rep hangs up on me.
- 4 March, 6pm. Another text message from Humana: “Hi JOSHUA. We’ve been unable to reach you regarding your medication. Please call 8662081251 (TTY:711) M-F 8a-5p, PST to receive important information regarding your health and medications. Text STOP to end messages. Text HELP for help.” I have no idea why they’re still texting me after calling me with a second, different phone number, but now I’m curious.
- 4 March, 6:05pm. I call Humana back. They greet me by name, then request me to verify my identity by giving my Zip Code and year of birth (real secure, guys). Then I ask some questions. Did you know you already called me this morning? “No.” Is this medication now approved? “I’m just a reminder, so I can’t tell that.” Can I ask about other medications? “I can’t get access to that information.” I tell the Humana rep that I am sorry they have such a silly job.
So let me get this straight. You texted me. You called me. Then you texted me and called me again.
You’re harassing me to remind me to refill a medication that you didn’t approve and you can’t tell me whether it is approved, when I can get it cheaper without using your insurance.
Insurance companies like Humana have no business whining about profits when they waste their money on stupid anti-consumer processes like this. Why bother with this reminder call? Why repeat it? And for lord’s sake, why wouldn’t you give the Humana employee on the other end of the call the necessary information to answer basic questions about my insurance?
It seems to me that Humana, the fourth largest health insurer in the US, with revenues exceeding $130 billion, can’t manage basic information systems or customer experience.
Somebody there is on drugs. It’s the only possible explanation.
Though I am required to have an insurance company for Part D of Medicare, I have found that Costco sells me my two prescription drugs for less than InHumana, less that GoodRX or any other plan. In fact one drug is n/c. If a Costco is near to you, I’d suggest getting pricing from them. I never have to present my SubHumana card to Costco
But you have to be a member of Costco. I once tried to visit Costco, to see how they compared to BJ’s, knowing full well that I couldn’t buy anything unless I was a member, but they wouldn’t even let me in. When I went in another time, with my boss’s business membership card, not only did the door monitors chase me down to show identification coming in, but I had to show it again going out, as well as at the check-out. I did not appreciate being viewed as a threat or interloper. It’s more than inconvenient to have to haul out the stupid card three times. Maybe Costco has modified its attitude since then (in the late 80s), but I’m not inclined to explore.
As I mentioned in my reply.. no membership needed, Sally. Just tell the people up front you’re going to the pharmacy.. never been an issue for me.
That’s good to know. Thanks! I may go check that out. My husband has issues with the insurance he has for Medicare – last year, an Rx we had been paying $35/month for suddenly jumped to $3200, with our insurance copay being a few dollars short of $1000 – that’s more than two-thirds of his Social Security benefit. Needless to say, he hasn’t been using that Rx since. I doubt that Costco’s pharmacy would carry it for significantly less (realistic for our limited budget, that is), but it’s worth looking into.
Insurance companies and the Prior Auth process is confusing and frustrating, probably on purpose.. I have had to chase my Dr to apply correctly, and the insurance company to review properly, ugh.. but David Kings, this is excellent info – Always, always check Costco.. you dont need to be a member to use the pharmacy. Though it can be a pain because the one near me only accepts Visa.. I don’t have one, so I need to use the ATM first which is near where they sell the $1.50 hot dogs, so, its crowded.
Or someone there isn’t on (the right) drugs. Probably couldn’t get their prescription filled!
Remember the movie about a health insurance company employee, who died because her own insurance company (her employer) refused to cover her cancer treatments? It’s probably 4o years old now. I’m not sure, but it may have been based on a true story. I don’t remember it as being a documentary. (I thought Terri Garr starred, but I must be mistaken, because I don’t see it in her filmography list.)
Thanks to all for sharing. The American public needs good advice and aggressive watchdogs against the rich and powerful.
There is no arguing with insurance companies. They have you over a barrel, and they know it. They don’t care that you know it, too. They know they don’t have to have a logical answer to anything. They know they don’t have to print consumer information in plain English. They know they don’t have to be consistent, when one agent contradicts another, when one “official” document contradicts another.
They don’t give a damn about your health and welfare. If you die, because you couldn’t get the medications you needed to maintain some semblance of health, there’s always another sucker (with no choice about being in the system) to take your place.
Like the slaves rowing a Roman galley: you’re expendable, for there is an endless source of replacements, to keep their profits rolling in.
I’m very happy with Wellcare. They keep adding drugs to their formulary rather than eliminating them. There was one eyedrop they took off of it and it turned out I was allergic to it.