Anger over Insurance

So I’m leaving for Kenya in five days. I’m trying to take care of all of those pre-trip details like packing, insurance and international calling cards. I dropped off a prescription for anti-malaria pills last Saturday at the Target pharmacy. I told them I would stop by the next day to pick them up. No rush.

Around 3 p.m. I get a phone call. Sorry we can’t fill your prescription without prior approval. So the pharmacy faxed a letter to the doctor telling them to send a note to my insurance explaining why I need the pills and to have the insurance company tell the pharmacy to fill the prescription. Of course, because it is Saturday no one is there. Thankfully, I don’t need to start taking the pills until this Saturday so I’m not too worried.

Monday morning rolls around. I bypass the doctor and call the insurance company.

Me: I received a call from my pharmacy saying that anti-malaria pills wouldn’t be covered.

Customer Service Rep: Why is the medication being prescribed?

Me: Umm, to keep me from getting malaria?

Customer Service Rep: So you don’t have malaria?

Me: No, not presently.

Customer Service Rep: Well, I’m sorry, but we will only cover that medication if it is being used for the treatment of malaria. Any preventative medication is not covered.

We get off the phone. I call the pharmacy. Yes, I can pick up the pills if I am willing to shell out $170. GREAT!

What really bothers me is that this makes no sense. Wouldn’t it be cheaper for the insurance company to pay some portion of the $170 to cover the anti-malaria pills than the actual treatment of malaria? (It’s not like they ever completely cover the cost of a medication.) I mean we aren’t talking about someone getting a cold or something insignificant. Malaria kills between 1 and 3 million people a year and causes disease in about 400 million.

Were someone to be infected, you are talking about doctor’s visits, possibly time in the hospital and medications. We are talking about thousands of dollars in treatment that could be avoided if people were able to have access to preventative medications.

What can I do?

I have to suck it up and spend the money to get the pills.