My insurance company is pushing Z drugs!

I just got a notice from my insurance company, in their efforts to get people to use generics, they're giving an incentive of 4 free refills if people will switch from their brand name.  If someone were to get a prescription written for 90 pills, this could mean up to a year of free drugs if you take one pill per day. 

 

One of the drugs they want people to move away from is Rozerem, they're offering Zaleplon and Zolpidem in it's place.  Rozerem is not in the same class of drugs are Zaleplon and Zolpidem, how can they do this?  Anyone who knows my story concerning Ambien will probably know how angry this makes me. 

 

Does anyone have any ideas for how I can get my insurance company to listen to reason, instead of keeping their eye on the almighty buck and putting even more people at risk?

 

http://en.wikipedia.org/wiki/Ramelteon

 

http://en.wikipedia.org/wiki/Zaleplon

 

http://en.wikipedia.org/wiki/Zolpidem

Pam, I really don't have any good suggestions except to call and read them the riot act.  But, I just wanted to say how angry these free-drug offers make me.  They are giving away free meds on the TV ads for Ambien and Lunesta.  I see them every night.  It makes me want to scream---which I do occasionally---at the TV.  I mean, giving away free drugs is not like giving away free magazines.  They are addictive!  So what these ads are saying is that we will give you just enough free medication to make you dependent (usually they offer a two-week free trial). Then we know we'll have you for life!  I can't even believe they are so transparent---at least to those of us in the know---and yet, of course they can get away with it with the drug-naive population.  And, they know exactly what they are doing.  It is totally unconscionable.  There's my rant.    L., ~~mbr

Legal drug pushers sanctioned by the FDA and the government of the United States of America! 

I'm having a similar problem of the insurance co. wanting to substitute a generic that is NOT the equivalent of the more expensive brand name drug.  I thought of asking my doctor's office to contact them but haven't looked through all the appeals procedures yet to figure out how is the best way to go about it.  I think all the health insurance policies have to have appeal (and grievance) procedures - if you can find out what they are! 

Finally!  A way to put my law degree to some good use.

 

Soon as I can get over this flu bug , I'm going to look into this and make some phone calls. I'll post back if I find out anything.

Sounds like the insurance companies are in cahoots with the Drug companies...........this HAS to be illegal, doesn't it?  We really have to be vigilant at all times ........how sad!

Is that legal where you are?

Is that legal where you are?

 

I'm not sure if you're asking me if it's legal, but I'm sure it is.  In their minds, they're simply encouraging the members to accept generics.  What I don't understand is how they can say that Rozerem is the same as a Z drug.  This means that those who are now taking it, will instead ask their Dr for the highly addictive and dangerous Z drug. 

 

There has to be a way to alert my insurance company of this mistake or some federal authority that this is being encouraged.  I don't want to be written off as a crackpot, this is serious!

Is that legal where you are?

 

I'm not sure if you're asking me if it's legal, but I'm sure it is.  In their minds, they're simply encouraging the members to accept generics.  What I don't understand is how they can say that Rozerem is the same as a Z drug.  This means that those who are now taking it, will instead ask their Dr for the highly addictive and dangerous Z drug. 

 

There has to be a way to alert my insurance company of this mistake or some federal authority that this is being encouraged.  I don't want to be written off as a crackpot, this is serious!

 

I was asking if it is legal.  I didn't think they could offer medical suggestions like that, especially misinforming people.

 

Could you see a local politician to give your complaint more credence?

Good point and suggestion, thanks!  I told this story at dinner last night with friends, I was of course waving my arms about, all passionate and incensed!  They just looked at me like, so?    At least you guys get me! 

Pam,

 

Why don't you write a letter explaing the difference in the two and hilighting potential legal risks associated with their actions.  You could not only emphasize the addictive qualities of the drugs but also all the horrible things people have done while on these drugs.  I don't believe Rozerem is implicated in the same kind of crazy stuff as Ambien.

 

-Ryan

Thanks Ryan, there is plenty of documentation to back up my opinion, as well as the basic chemical ingredients and mechanism of action.

I called my insurance company, they shuffled me off to the company which handles their retail and mail order drug program.  They then told me to take it back to my insurance company, or talk to my doctor.    I'm not done yet, but having just spent the last 20 minutes on the phone makes me realize this is going to be an uphill battle! 

 

 

 

I think they count on people giving up because of frustration with the bureaucracy, but they got a tiger by the tail this time! 

You go, girl!

Thanks ladies, I started losing interest until I saw your replies, I'll jump back into battle on Monday.  Has anyone ever seen the Seinfeld episode where Elaine gets a notation put in her chart that she's difficult?  He won't treat her after that and she can't find another Dr who will either.  While I was pursuing this yesterday I thought about that and knowing they record phone calls, wondered if this was going to cause me to get a notation in my chart. 

OMG!  Totally laughed my head off!  I'm sure that's why I've not been able to find a decent doc!

 

 

OMG!  Totally laughed my head off!  I'm sure that's why I've not been able to find a decent doc!

 

 

 

Probably!  Think about it, we've got this support forum, I wonder if the Dr's do too, maybe they're all complaining about us like we complain about them. 

Isn't it an antitrust matter? That is how I would attack it.

...what I mean is, when we enroll in a certain insurance plan we are bound by certain restrictions to use certain doctors...the doctor could be considered the "product" . Doctor's pay our insurance companies a portion of our office fees (kickbacks) to be listed on our provider lists. BUT...is it different when an insurance company is also representing a drug company? Is this unfair competition? Does this violate Antitrust? or any other laws?

Hi WW,

 

Thanks for explaining that, wow this is something I'd not considered!  I'm going to do some further research, thanks! 

Thanks ladies, I started losing interest until I saw your replies, I'll jump back into battle on Monday.  Has anyone ever seen the Seinfeld episode where Elaine gets a notation put in her chart that she's difficult?  He won't treat her after that and she can't find another Dr who will either.  While I was pursuing this yesterday I thought about that and knowing they record phone calls, wondered if this was going to cause me to get a notation in my chart. 

 

Classic Seinfeld, I love that episode.  The way the doctors keep giving her a stare and writing in their chart hahaha Funny episode

And poor uncle Leo

Yeah, poor Uncle Leo got some serious eyebrows out of the deal! 

Health Insurance: from ebuy.com

 

 

World » Finance » Insurance » Health

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How to File a Health Insurance Complaint

If you feel your health insurance company or agent has acted illegally or improperly there is a simple process to resolve the issue:

First and foremost, keep detailed records of all relevant documents. Write down all conversations you have had with your agent / company. Keep all written correspondences in one folder. Save copies of canceled checks, bank statements, or paystubs with payments to the insurance company. Find and read through your policy agreement.

 

 

Contact your insurance company’s customer service department. Explain your complaint and give them a reasonable amount of time to address the issue.

If you still don’t feel that the issue has been resolved, you can elevate the dispute.

Consider your legal options. If the dollar amount in dispute is large, consider contacting an attorney to explain your problem and get their advice. Usually getting a referral from a friend is the best way to find an attorney. If this doesn’t work, you can try using an online lawyer database. For smaller dollar amounts, you may want to file a small claims suit. The dollar limit for small claims are set on a state by state basis.

 

******************************************

Contact your state insurance commissioner. Almost all state commissioners have complaint forms on their websites (see State Insurance Sites for a list of state insurance departments). After filling out the form and submitting it, someone from your state will likely contact you to ask a few follow-up questions and may ask for supporting documents. Next, the state insurance department will contact your insurance company to discuss the issue. Afterwards, they will either contact you to tell you that they are closing their investigation, or they will transfer you to a specialist in the insurance department to continue working on resolving the issue.

 

 

Contact the Better Business Bureau and file a complaint with them as well. Health insurance companies work hard to resolve complaints because they hurt sales. Many people check with the BBB before buying insurance.

If all fails, you still can warn others about the practices of your company/agent.

Share your experience on consumer opinion websites such as epinions.com or consumeraffairs.com

 

Pamster, I think the last 2 paragraphs may apply to your problem.  There is also a state board of insurance for each state, that includes health insurance complaints (if you are in the US)  Maybe ask the BBB where to go to complain as well...

 

Good luck and let us know.

Robin

Hot dog, thanks Robin!  I've got a road map to follow!