Insurance people be cray-cray.

My lovely wife had cataract surgery, right eye. She was prescribed three types of drops -- antibiotic, NSAID, and steroid -- to be used several times daily.

Three weeks after the right eye, the same procedure was done for the left eye. The clinic sent the Rx for drops to the pharmacy. Surgery was in the morning, I brought her home then went to the pharmacy to pick up the drops.

NOPE! Insurance says it's too soon for a refill. Got to wait two weeks. Assholes!

I told the clerk that I needed to speak with the pharmacist. Explained to the pharmacist that the surgery had been done that day and wife needed to use the drops every two hours for the first day. Gave her (the pharmacist) a copy of the post-op instructions that included the date (that day) of the surgery, and asked her to call the insurance company, telling them that she (pharmacist) had documentation in hand and the drops were needed right now! Told pharmacist that if insurance balked at this, I would like the full name and business address of the person who denied the request, along with anything that person would like to say in his / her defense when I contacted the state insurance commission.

Pharmacist said it might take a while, so I ran an errand. When I returned, pharmacist told me that she had obtained insurance approval. I'ma write a letter to the company (Publix) mother ship, praising the pharmacist for doing battle with the insurance company (Aetna / CVS) on my wife's behalf, as well as a letter to the state insurance commission, blasting the insurance company.

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Side note: in a previous thread, I had mentioned that one of the drops -- the steroid -- was really irritating my wife's eye after the first surgery. One of our SIGforum eye docs, either bcereuss or CGC, I don't remember which one, suggested using the brand name steroid instead of the generic. I requested this from the pharmacist for my wife's second eye. Pharmacist got approval from insurance company, co-pay was only $173.00 for a tiny 5 ml bottle.

My wife stated that was nonsense, her eye was irritated but did not fall out of her head with the ten dollar co-pay generic, so she would stick with that, which she did. Fortunately, she did not have the same adverse reaction with the second eye, so we did not wind up spending an un-necessary extra $163.00.

All about the money. Like the pharmacist wants to spend time talking to the insurance company. At least she is an employee and is on the clock. There needs to be more movement towards limiting preauthorization requirments. There has been some recently, but not enough.