This Just Happened At My Local Pharmacy: One Dose Of Nauseating Truth About Health Care In America

My doctor recently prescribed a new medication, to be taken four times a day.

"But make sure to check with your insurance," he advised. "Some plans will only cover it twice a day. If that's the case, just let me know."

And like a dolt, I got busy and didn't call insurance.

Nearly two weeks ago, I dropped off the script at my local Jewel-Osco pharmacy.

The pharmacist entered it in her system, then scratched her head. "This medication is only covered twice a day," she said, shoulders raised and lower lip stretched tight across her teeth. "Sorry about that."

Damn, I thought. My bad. "Okay," I said, wheeling my cart around. "Thanks. I'll have to call Blue Cross Blue Shield to straighten this out."

"Actually," the pharmacist said, raising a hand. "Let me call your doctor directly. If he writes the script a different way, it'll probably go through."

Ah! Great! I said.

And I went home.

I called Osco the next day.

"Sorry...we haven't heard back from your doctor."

I called Osco the following day.

"Still no word from your doc."

Then I called my doc directly and left a message: "Would you please call my pharmacy? Here's the number [xxx.xxx.xxxx]. They said you could write the prescription differently, and it should approve 4 doses every day. Thanks."

I called Osco the following day.

"Nope. Still nothing. Sorry. Have you tried calling insurance?"

Ahhhhhhh.....this is actually all MY fault. Shoulda done that from the start. "Okay, I'll call insurance."

I called Blue Cross Blue Shield. And they said, "Yup. All four daily doses are approved. You're good to go."

"Wait. You're SURE?" I asked.

"Yup. If your pharmacist has any problems, have them call us."

"Cool," I said.

Then I called the pharmacy. "Insurance says I'm all good. When can I pick up my medication?"

"It'll be ready tomorrow," I was told. "But only two doses a day."

"Nope," I said, all confident and self-assured. "Four doses. I have confirmation from insurance."

"Hmmmm," the pharmacist said. "Okay. We'll straighten it out on our end, then. C'mon in tomorrow after 4. We'll have it ready for you."

I even wait an extra day, because I'm not scheduled to start the medicine until next week. During this time, I even receive a voicemail from Osco, saying my prescription's ready for pickup. Excellent.

I show up at the pharmacy the next day, yesterday, around 1:15pm.

There is no line.

Jackpot.

I walk up to the counter and say, "I'm here. Lemme have it."

(Actually, I don't say this, but you know that I wanna)

And I'm still feeling hopeful.

I'm still giving the pharmacy staff and the insurance company the benefit of the doubt.

I think, This must have just been a wacko glitch in someone's computer. We're all good now. Just give me my medicine so I can go home and make myself lunch. 

"Okay, Ms. Wolf," the pharmacist says. "You're all set."

Great!

I pull out my wallet and wait to hear what the copay is.

That'll be $489.99."

"Say what?" I ask.

"It's not covered at all," I'm told.

"Come again?"

"Insurance denied the whole thing."

"What are you talking about?" I ask. This is nauseating.

I notice a woman behind me, leaning unsteadily against a grocery cart made for little kids, the kind with a red plastic car and two little steering wheels at the front. She's pushing the cart dangerously near my ankles as I speak to the pharmacist.

"Your insurance won't cover this," I'm told.

"But that's just wrong," I say. "I spoke to them myself. They said it's covered."

"I don't know what to tell you," I'm told.

"Okay," I huff. "I'll call Blue Cross again."

I take a seat in the waiting area, pull out my insurance card, and navigate Blue Cross' phone architecture to find someone, anyone, who'll help me figure this out.

I'm transferred multiple times...and as I wait...and re-explain...and grow increasingly annoyed...I watch the woman pushing the vroom-vroom cart. She has a splint on her right ankle and a cast on her left wrist. She's mumbling to herself, pacing up and down the pharmacy aisle, her eyelids heavy, her gait increasingly unsteady. The temperature outside hovers around 80, but she's wearing several layers, including a jacket. It's unclear if she's wearing any pants.

Finally: "Blue Cross Pharmacy Line. How can I help you?"

I re-explain what's been happening, that I just want my medication, that I'm being told it's not covered.

"Well," Blue Cross says, "It's too soon to refill."

"Refill?" I say.

I'm watching Ms. Vroom-Vroom amble toward me. She sits down hard in a chair next to the self-serve blood-pressure chair/device/thrill-ride-for-bored-kids-grocery-shopping-with-overworked-parents.

"Look," I say. "I haven't even gotten the first dose yet. I'm here at the pharmacy, trying to do that now."

The low battery indicator goes off on my mobile phone. Great.

"According to our system," Ms. Blue Cross says, "you've already picked up your first 30 day supply."

"But I haven't picked ANYTHING up," I say.

Ms. Vroom-Vroom has now fallen asleep in her chair, reeking of alcohol. It's mid afternoon.

"I've been trying to get my medication for days," I say.

"That's so weird," Ms. Blue Cross says. "I don't know what to tell you. I'm looking right here at the screen. The order was filled a few days ago."

I'm so irritated. I'm hungry. And I'm thinking hard.

And then I have an idea.

"Wait!" I say to Ms. Blue Cross.

My voice startles Ms. Vroom-Vroom, waking her momentarily, though she returns immediately to her slumber.

"Maybe someone at the pharmacy processed my original prescription, before they called my doctor? They said something about only two doses a day getting approved. I really don't even know why this is taking so much effort..."

Ms. Blue Cross says, "Maybe I just need to speak to the pharmacist directly?"

"Yes please," I say. "Because I'm here now."

"Do you mind if I put you on a brief hold?" she asks.

"Are you kidding?" I say. "I'm not hanging up until I walk out of here with my medication."

TWENTY MINUTES LATER I'm still on hold.

And that's when Ms. Vroom-Vroom begins her projectile vomiting.

And this is not a dribble.

This is like Old Faithful, rumbling to an explosive, spectacular display of kinetic energy, spewing a geyser, all over the floor, splashing the kiddie grocery cart, the chair, the blood pressure ride.

And as I launch myself from my seat, cheery Blue Cross Blue Shield music pipes through my headphones.

Ms. Vroom-Vroom is still not fully conscious. I'm convinced she's going to choke on her own vomit, which has now transformed the smell of the pharmacy waiting area into one of a microbrewery.

"Are you okay?" I'm asking her, my voice raised. Then, "You're okay. You're going to be okay."

She's slumpy and not responding.

From behind the counter, the pharmacist calls to me: "Is she throwing up?"

Her voice has more *disgust* than I'd expect from a pharmacist. She's now holding the phone away from her head, craning to get a better view.

"Yes," I say. Eyeroll. Obviously she's throwing up. Use your nose. Look at the floor. "I think you should call 911. I smell a lot of alcohol..."

The pharmacist nods, just as the store manager appears.

I'm crouched down in front of Ms. Vroom-Vroom, about a foot outside her pool of puke. She's opening and closing her mouth without opening her eyes.

"Can you hear me?" I ask.

Nothing.

"You're going to be okay," I say.

She opens her eyes. They are terrified. I want to tell her to keep breathing, but I'm worried she'll choke on her own vomit.

"Can you spit?" I suggest, still crouching.

She opens her eyes. They are vacant.

"I think you should spit," I say, nodding, forcing a smile. The calming Blue Cross music isn't doing shit. I'm scared, but I know she's scared-er.

She spits a little, revealing her gnarly teeth.

"I'm sorry," she slurs. "I don't mean to make any trouble. I'm just here to get my medicine. My arm hurts."

The manager and I respond to her statements with positive words.

Of course.
You're okay.
Someone's coming to help.
We've called 911.

"I can't go to St. Francis Hospital," Ms. Vroom-Vroom says, sitting up straight.

That's okay, we say. You can tell them where you'd like to go.

And then, she stands up and announces she needs to go outside.

Like, right now.

She says she needs a cigarette.

She steps through her vomit and leaves her shopping cart with her purse and bags of clothes.

"I think you should sit," I say.

"I have to go out now," she insists.

I look to the manager. "Are you going to follow her? I'll stay with the cart."

"Yes," he says.

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The pharmacist waves to the manager. "Just so you know, I can't fill the prescription she just dropped off. It's for pain medication, and [pointing to me] this woman says she smelled alcohol..."

The manager confirms what everyone from here to the meat department can already smell: The woman is drunk.

And then he's gone.

"Hello?" Ms. Blue Cross says into my ear.

"Oh hi," I say. "Sorry."

"I'm so sorry for the wait. Look. I don't know what's happening, but the pharmacist put the phone down, and I don't know where she went."

"Okay, hold on," I say, walking around the mess on the floor. I approach the Osco counter. "Excuse me?" I say. "Is anyone speaking with Blue Cross right now?"

"They put us on hold," someone behind the counter says.

"Wait. I'm talking to them right now. They say you've put THEM on hold."

Now I'm PISSED. I am so, freaking, pissed.

"We're working on it," I'm told. The pharmacy tech is counting out pills and sticking labels on little white bottles.

Meantime, the store manager, after having brought the kiddie cart out to Ms. Vroom-Vroom, comes back and instructs a stockboy to clean up the mess. "And use the treatment for bodily fluids," he says.

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I am so disgusted. With everything.

I don't want to touch anything.

I don't want to buy anything.

I don't want to be here.

But I'm determined to see this through and get my medicine and walk out of here without giving up. So I go back to my stupid seat next to the stupid pool of bodily fluids and continue to hold while Ms. Blue Cross, who's probably in an office park in Omaha, works her magic trying to talk to the lady five feet away from me behind the counter here in Evanston, Illinois.

I'm just the patient, trying to get the goods. I just want to feel better.

I watch the stockboy dip his nasty gray mop into a bucket, slopping up Vroom-Vroom juice as I try to focus on building a new Spotify playlist. Anything to keep my mind off this. Anything. Anything.

Just don't look at the puke. Breathe through your mouth. Build the playlist. #keepgoing

How many times have my own kids ridden in one of those red plastic cars, eating Cheerios they pour into the little cup holder?
How many times have they played with that blood pressure device?
How thorough is this stockboy being with the cleanup?
Does he know he missed a spot of Vroom-Vroom juice over there?

Don't look. Just breathe.

"Okay, Ms. Wolf," the pharmacist says. "Thanks for your patience. They approved it. Your copay is 58.07."

After nearly three hours, I stand up and walk back toward the pharmacy counter, stepping across the linoleum, still shiny and slippery slick, and reach for my wallet.

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    Christine Wolf

    I cover life's ups and downs, but I'm really drawn to the tough, emotional stuff. I'm always willing to voice an opinion, though it often contradicts my innate desire to please everyone at all times. Such is this crazy life, so I guess all I can do is just write about how I've (usually) kept my head above water. Thanks for dropping by. I'd love to hear your thoughts.

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