Kaiser Permanente / health insurance

Tualatin, OR, United States

This is why I HATE Kaiser Permanente. I left them under ACA, but had to return this year. Have a Lupus Rx I have to refill monthly. Started trying weeks ago. Now basically out. They finally fit me into my former primary care today. Actually had a great, encouraging visit. Even thought they were an hour late seeing me. Then another 30 minutes by which point the Dr had left since it was after 5pm. Pharmacy finally has the Rx, but at retail, which is like $300. Saying they wouldn't pay for it. Mind you, my records indicate that I have filled EXACTLY the pre-reqs they require. Which is why, under the EXACT same health record # in 2015 & earlier it was covered. But their billing dept isn't looking at that, or the scanned documentation that originally facilitated the approval. Even after the pharmacist’s third call where she told them she can see it. KP billing just parrots off that I will have to wait through an appeal process. The poor pharmacist was caught in the middle, and the Dr can't be reached. I AM TIRED, FURIOUS AND DEFINITELY NOT "THRIVING" UNDER KP. Don't get me started about my multi-year battle with them over Sjogren's being medical not dental.

Jan 19, 2017

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