Held Hostage by Health Insurance?

This is a blatant rant against insurance companies — so I don’t blame you if you want to skip this post!

I HATE INSURANCE!  ALL insurance, but especially health insurance.   On the other hand, after seeing David’s medical bills from last summer with his heart issues, I’d really rather not go without.  So I guess we’re lucky to have it, at least until next summer when he goes on Medicare and I’m stuck looking for my own insurance – there’s no way this is going to be less expensive than what we have now.   🙁

I’ve always heard stories from other cruisers about trying to get enough of their medication that they can go cruising for an extended period of time and still take the medication prescribed by their physicians.  In the past neither of us has taken ANY prescriptions, let alone important ones like David’s heart stuff, Plavix & Lipitor.   David’s cardiologist assured us that taking the medications would in NO WAY cause us to change our lifestyles.  I’m seriously wondering how he thought that was possible.

So for the last two days I have spend HOURS on the telephone with Caremark — the CVS prescription plan that works with Blue Cross Blue Shield of Texas which is our health insurance.  We want to be flexible enough to leave U.S. waters for six months at a time, but NO…. damn insurance companies will not allow any more than a 90 day supply.  Why NOT???  It’s not like we’re drug addicts trying to sell the Plavix or Lipitor for profit … or even abuse it for our own weirdo highs…

David & Jan in the San Blas Islands, When We Didn't Have to Worry About Getting Six Months of Meds to Leave & Enjoy!

David & Jan in the San Blas Islands, When We Didn't Have to Worry About Getting Six Months of Meds to Leave & Enjoy!

CVS/Caremark checked out the insurance policy limits and after promising us a out of the country “vacation override”, Blue Cross Blue Shield said we didn’t have the vacation override.  Huh?

So after wasting literally 4-5 hours on the telephone we’re back to square one. No Plavix, no Lipitor…. we can leave here & “go cruising” but we have to be back in the U.S. by March 15.  Anyone that’s cruised knows that there’s no predicting the time you’ll be hung up waiting for weather or other factors out of your control.

After a bit more research, since Lipitor just came off the patent, we can buy the generic for next to nothing a month (THX John on the Cruising Sailors Bulletin Board), so that solves half the issue.  Now on to Plavix — I was told earlier today that it’s $220 a month if we buy it outright.  Hmmm….  But even Plavix is vulnerable because it’s patent expires in May 2012.  But in the meantime, we want to leave the U.S. NOW until early June 2012… so it would be really nice to have a six month supply, or at least a five month supply.

In the meantime, why do insurance companies have the right to decide what medical procedures we’re allowed to have, what medications we’re allowed to take and for what amount of time?  Shouldn’t DOCTORS be deciding these issues? Insurance companies should be ASHAMED!   Abusing normal healthy people that require a bit of medication is NOT what we anticipated as we retired & grew a bit older.

David’s answer is to just quit taking them and go cruising,  after all, he has no symptoms and no limitations in our daily lives other than the INSURANCE RULES!   But just in case the cardiologists DO know what they’re talking about, I’d feel better if we had enough meds that we didn’t have to worry about being at any location for sure at any specific time frame — all cruisers know that’s a recipe for disaster.

Anyone out there that has an answer for this ridiculous Catch 22, PLEASE leave a comment.  Lipitor isn’t an issue and Plavix will cease to be an issue soon, but what happens if one of us is prescribed a newer drug that isn’t due to come off patent pricing anytime soon?  Then we have to decide between cruising (i.e. life) and the medications?  Something is just not right with the insurance situation in our great country.  🙁

Comments

  1. Candy Ann Williams via Facebook says:

    Good luck!! It is really frustratingisn’t it?! Is there any other drug your cardiologist could substitute for the Lipitor ? Even if it wasn’t as ‘good’ as the Lipitor it would be better than not taking anything….just thinking… I just made a car run to Mexico so I could stock up on my husbands meds so we could have our supply. So I understand your rant-good luck!!

  2. Great article! We can’t offer any advice, but feel your pain … we hate insurance too! Best of luck.

  3. Debbie Carroll via Facebook says:

    One option is to have cardiologist double the dose and then you cut in half. I know they do this for some medications.

  4. Well, based on what I’ve known other cruisers to do:

    1. Pay for the drugs out of pocket wherever you are. That’s what we did. Not cheap, but it let us do what we wanted.

    2. Are you actually going to be out of the US for more than three months? Time the trip so that you get a three month supply in your hopping-off spot and then get meds immediately when you get back. Many, many boats in the Sea of Cortez did this.

    3. Take a quick flight back to the US to pick up the meds. Lots of cruisers in Mexico flew back or took the bus. We always thought it was cheaper to just buy our meds where we were.

    4. Invite a guest to visit and bring your “mail” — including the meds. There can be issues with meds with a different name on the bottle, though.

    5. Have your doctor “prescribe” double the daily dose, so that your “3 month supply” actually lasts 6 months.

    You have to be a little flexible and creative, but just remember that many (most?) cruisers take daily meds. They all figure out solutions.

  5. Bill Shuman says:

    There are online pharmacies that have much lower prices. I have been researching how we will afford our medication when we start cruising next spring. Try this one:

    http://www.canadapharmacy.com

    They have generic Plavix (75mg) at $156/100 pills. A prescription is required and they only ship to the US. Other US sites only have the brand Plavix at about the cost you mentioned. Another alternative is to see if there is a different medication the doctor can prescribe that is generic and less expensive. The nice thing about the above site is that you could get your 90 day supply from your insurance company and get additional pills from the online site to extend your cruising time. You could probably buy multiple orders of 100 pills since it’s the insurance company that is restricting how much you can buy.
    Good luck!

    • THANKS Bill! Great information. We were finally able to get our insurance company to get us the 6 months supply, but we’ll keep this in mind for next winter! Cheers! Jan

  6. I think insurance companies are hesitant to write prescriptions for six months because if you die, they’ll have wasted money. I don’t have insurance because it’s much too expensive, so I was able to get six month scripts for my three drugs. Two of them are generic and cost a total of $50 at Sam’s Club (you don’t have to be a member to fill prescriptions there). The one that is not set me back $825, but I figured that I’d be spending that money anyway.

    • I think you’re right, but David has no intention of dying … and if he does, I’ll KILL him! Talk about no way out, huh? I have big plans for him and they do not include dying! 🙂 — Cheers! J

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