The way insurance companies work is so backwards sometimes.
We’ve had plenty of times where rather than pay for a medication, they want you to try 3 others first. The kicker is that trying those 3 meds first almost always costs way more than just paying for the original medication in the first place.
This time however, the medication issue isn’t something that I even understand.
Gavin takes prescription sodium chloride tablets because of his autonomic dysfunction. It essentially helps prevent a crisis by forcing his body to retain water.
Gavin’s body doesn’t manage things properly. One of those things not properly managed is his circulatory system.
His vessels don’t constrict to maintain his blood pressure when he stands up, for example.
The sodium chloride forces his body to retain more fluids, thereby making it easier for his body to compensate without crashing.
These are absolutely medically necessary and Gavin’s been on it for years now.
I went to pick up his refill this week and out of nowhere, insurance is refusing to pay for it without a prior authorisation.
Gavin’s got half a days worth left and as of this evening, it still hasn’t been approved. I spoke with the Cleveland Clinic and they are working on it.
I don’t know why they did this and it’s really frustrating but everything that can be done is being done.
I’m going to talk to the pharmacy in the morning about an emergency supply. They should be able to do that.
For the record, there was no way to predict this was going to happen..
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