Blue Shield of California denied my antibiotic. It’s open enrollment now. Suggestions?

No one expects to have a positive experience with an insurance company. I get that. But this one is far below average. The company is trying to boost profits by denying micro claims and it’s just causing me way too much frustration. There is no reason for this but to squeeze every dime out of subscribers.

I know our family’s medical expenses are not covered. I know that this disease is too “new” and too “expensive” to treat. I get that and I pay for the insurance for emergencies only and for them to cover anything in the off chance that it falls under the “normal” treatment umbrella.

So when my doctor prescribed an antibiotic, I assumed it would be covered. Well I assumed wrong. It needed prior authorization. Okay, I assumed it would be straight forward. Well I assumed wrong.

To make a long story short. Blue Shield apparently knows much better than my doctor and I should “try” two other antibiotics first before getting the one my doctor thinks will help my gut infections without causing more systemic harm.

This is a petty petty company. I already pay over $30,000 in out of pocket medical costs every year because they don’t cover those doctors and things. Okay. But they couldn’t even pretend to want to be helpful and pay for one two-week prescription of antibiotic. Between my employer and I, we paid $30,465.00. And they are coming out ahead by about $23,000 on me for 2022 alone. Needless to say I will never do business with them again.

So I did go to good RX and I paid $2,134.56 for two weeks of antibiotics.

I hope to save someone the heartache in the future. Also, talking to people, I learned from a friend that is older that the same thing happened to him 20 years ago. He also never went back to them. I guess things haven’t changed at all.

Luckily, it’s open enrollment and I want to do my Homework before choosing a company. I won’t use insurance doctors, so I don’t care about that. But I need the best coverage for prescriptions. Antibiotics, cholesterol stuff, weight loss stuff.

Any suggestions?