Tuesday, May 1, 2007
So this is the story of me trying to get Plan B.
Mind you, I didn’t need it. But condoms have broken on me before and I know my hospital, I know my insurance, and every interaction I’ve had with either has brought me to tears of frustration (and I don’t cry easily). So I’d rather have the peace of mind of already having it on hand (knowing it's good for two years) and already having gone through what I needed to go through in getting it when I’m not actually in a moment of crisis.
I go to my local pharmacy in New York City’s Grand Central Station’s Rite Aid after work. It’s always hectic, crowded, lines everywhere, and no privacy when you’re talking to the pharmacist. No one’s in the mood to be nice—ever.
I ask for Plan B. I show ID. No problem, the pharmacist is ready to hand it over. The pharmacist says its $45.
I don’t have $45.
I say, “Does this mean my insurance won’t cover it?” She kind of shrugs, disinterestedly. “You have to have a prescription to see if your insurance will cover it.”
I look at her. “Doesn’t that undermine the whole point?” Getting a prescription=lost time. Plan B needs to be taken within 72 hours, the sooner, the more effective it is. That’s why it was put over the counter. “Isn’t there something we can do to find out if it’s covered?” (i.e. look in the damn computer, please, I am thinking. One thing I’ve discovered about my pharmacy is that the people there HATE looking something up on the computer. You have to stare them down and they will literally drag their feet to it. But I can’t really blame them. About every other month we have to go through this whole thing of whether the computer says I can get a prescription refill or not. I can only guess I’m listed multiple times with old expirations.)
“Can we call someone, maybe?” I suggest. My voice trails off. In my head I’m thinking, ‘call who?’ I’ve never been able to reach my primary care doctor. Not once. In the two and a half years that she’s been my primary care doctor, I’ve only met with her for a single visit and I had to make the appointment four months ahead of time. By then I wasn’t sick anymore, but I kept the appointment to meet with her anyway, and she acted like I was wasting her time.
“Hold on,” the pharmacist says, and goes to the computer, tapping away.
“You need a prescription,” she says, and turns away from the computer. I understand this does not tell me whether or not my insurance covers it, or by how much, just that I would need a prescription to find out.
“You can have a doctor call it in,” she suggests.
I thank her and step away from the counter to think. I could try calling the hospital and catching a doctor from my cellphone. But if I actually got a hold of someone that would mean talking about my sex life in a Rite Aid where people are constantly jostling each other in narrow aisles and hearing everything I say. And I don’t like talking on cellphones in public normally.
I decide to call when I get home in about a half hour. By then it is 8 o’clock. I am tired and hungry.
I have three phone numbers for my hospital, but only two tend to work. They are primary clinic numbers, which means they are operators. Whenever you call to speak to someone, they ask why. You can’t just say, I need to speak to a doctor. “Why?” Because my prescription isn’t working for… and they link me to the medical dept, etc. Note, they’re not nurses or doctors, but they are judging your condition nevertheless. I understand the system, but it can be humiliating, e.g., Yes, I need to talk to a doctor NOW because I have vaginal irritation and nothing is working. (just as an example) See what I mean?
Amazingly, someone answers the phone the second time I call (first time the line was busy). I have never gotten through so quickly. There is a reason for this.
“Oh honey, the clinic is closed. Unless you have an emergency, there are no doctors available.”
Of course.
Getting Plan B is urgent, but it’s not an emergency. I explain my circumstances, and ask her if this happens often. Though sympathetic, she explains that she monitors this line for emergencies only, that she has the number to one doctor on-call and that if she calls him, he will be angry because he is concerned with life or death situations. I understand.
“I’m not even at Bellevue Hospital,” she ends by saying.
This makes perfect sense to me. This woman is communicating to me at a level I am unaccustomed to. She is not shouting into the phone, she is comprehensible, she is actually willing to offer information, she is listening.
“Besides,” she adds. “He will want to know why you didn’t call earlier.”
At this point, I refrain from pointing out that people don’t always have sex during normal business hours.
How does this end? Well, I have to call back tomorrow.
Wednesday, May 2, 2007
8:33 a.m.-8:58 a.m.
I called 6 times.
The primary clinic numbers work like this: They don’t. You can’t get through. I was astounded to hear that a friend of mine actually had her doctor’s e-mail, and that she could actually email questions or concerns and he would actually respond in a timely manner. Maybe it’s because I have low-income insurance that that’s not possible, but wow, wouldn’t it be nice.
The phone service at Bellevue Hospital does not allow you to wait on hold until your turn to speak to someone. It informs you all representatives are busy, please try your call at a later time. It says this all day, I know. I typically have to call an average of eight times to speak to anybody. It also offers you the option to get called back, by pressing #3. When I do that, I am told the number I am trying is no longer in service.
I am always in search of another, more direct phone number. I was given a number of my doctor, but that never worked. Every time I get connected to someone, I ask for that number. They give me the main numbers I already have.
At 8:58 I get through, explain my situation and am told I have to call back at 9:30 am. I have no idea why. When I try to press for why, the woman repeats loudly over my voice to call back at 9:30.
But I should of just waited on the line because it was 9 am and it took me a half hour to get through in the first place.
I can’t get through at 9:30.
I call four more times.
Get through around 9:40. I recount my situation three times, am transferred three times. Put on hold.
No one who picks up the phone ever identifies herself, or what department I’ve been transferred to. This annoys me to no end.
“Am I speaking to a doctor?” Is my first question. No, I’m speaking to a medical coordinator. What the hell? I keep asking for a doctor. I am told my primary care doctor is not in today, but will be in tomorrow. I ask to speak to another doctor.
“What about?”
I explain.
“Well, you’d have to come in for a visit. A doctor is not going to write a prescription without seeing you.”
“But it’s for an over the counter drug,” I protest. “It’s just so that my insurance recognizes it.”
She said maybe my doctor would do it, but all of the doctors here would have to see me. I gnaw on this a few seconds and then, though I know I don’t actually need this prescription, my frustration has become very, very, real.
“I’m really concerned here,” I say. “I only have 72 hours and I’ve already been trying to do this for a day.” The tears, which are on the verge and are real, are audible in my voice.
Please hold.
I listen to a series of Public health announcements.
Such as, “Feeling depressed? It is normal to feel depressed some of the time, but not all the time. Here at Health Plus we have mental care services available…”
This is disturbing to me on so many levels.
When the “coordinator” gets back on the line, she says that my primary doctor is actually just working in a different section of the hospital, and that she will walk down the hall and ask my doctor if she will call in the prescription. She gets my number. I ask her name “In case our lines get crossed” and her number. She gives me the operator’s number again and mumbles a name which sounds like “Cassie.” I imagine what fun I would have calling these numbers again and asking for a “Cassie.”
So I wait. I have no idea when my doctor will call, if she will. I imagine how busy other people’s lives are—who has time to deal with all this?
Somewhere between a half hour and forty-five minutes later my doctor does call, and after my explanation, she cheerfully, easily, agrees to call my pharmacy and put in the prescription.
Done.
The last thing I did was call my insurance to find out if it actually covered Plan B, and if so, how much of it, and was the Rite Aid pharmacy correct in telling me my insurance would not cover something over the counter.
This conversation would take another four pages to explain and we’re all tired. Let’s just say it took quite a while before it became apparent I had to explain Plan B was a drug and fumble through what it was for (which was very embarrassing).
Yes, now that I had a prescription put through, I was covered.
But no, my insurance does not, will not, NO insurance I was told, will cover something that is over the counter. I was offered the examples of Motrin and Tylenol. If I want my insurance to cover them, they better be prescribed. It didn’t matter that time was specifically critical to Plan B’s effectiveness—and it’s not like I’m a zealot or anything, I just want to take medicines that actually work. No there is no one to write to, no appeals process, no, I was told, “policies don’t change,” quote unquote.
The end.
- A.M.
