One day before my wife is scheduled to undergo surgery, Express Scripts refuses to pay for the pain killers prescribed by her doctor on the basis that there are cheaper alternatives.
Our doctor called to explain that there are no alternatives without detrimental side effects and he insisted on this medication. Express Scripts still refused to cover it.
Instead of relaxing the day before surgery, we have spent hours on the phone getting bounced to different departments and a full blown runaround. Even the appeals procedure the have put in place is designed to deter you from fighting their verdict. I must now have my doctor take time from his busy schedule to write a letter explaining why he insisted on prescribing the medicine. We then have to send it to them via snail mail and wait for their comittee to decide.
Long story short, we don't have a choice but to pay for the medications out of pocket. It is no wonder there is a nationwide debate on healthcare and reforming crooked companies like this one.
There is a special place in hell for the employees of this company that perpetuate the fraud and participate in denying claims.