Screw you, Curascript. And as for Blue Cross? Inhumane, greedy, disgusting.

Once again, Blue Cross has created a new “tier” of pharmacy benefits – Tier 4, a.k.a. “specialty” drugs a.k.a. a long list of medications for the treatment of HIV (they’ve included a few cancer and other drugs as well – though literally every single medication used for the treatment of HIV is now Tier 4) and for which there are no alternative or generic medications.

And what is different about this tier? Well, rather than a standard co-pay (it was $30.00 per prescription in 2012), patients are required to pay 20% of the cost of the medication or $150 maximum. Since all of the medications are expensive, the bottom line is that most co-payments are $150 or close to it, i.e. a 400% increase in out-of-pocket expenses for those being treated for HIV. In other words, Blue Cross has specifically targeted their most vulnerable patients as a new source from which to wring profits. Despicable.

Oh, and that’s not all. As a user of a “specialty” medication, I am now forbidden from getting my prescriptions from Walgreens or any other pharmacy (unless I want to pay full retail price). I have to use Curascript and do all of my ordering via phone and mail – that’s right, no option to do anything online. Yes, patients are required to always speak to a pharmacy rep to deal with any transaction or issue. This seems counter-intuitive, given the expense of paying actual people to interact with customers over the phone and Express Scripts’ (Curascript’s parent, natch) focus on profits before patients – until one realizes that the frustrating and time-consuming nature of such a system is going to result in patients receiving their medications more slowly (or even giving up on Curascript altogether) thus positively impacting Curascript’s (and Blue Cross’) cash flow.

My initial sign-up took around 30 minutes – a frankly ridiculous amount of time, given that I’ve been taking the same meds daily for nearly a decade. But other than that, it was fine. But I knew better than to expect things to run smoothly…

Several days later, I received an automated voice call from Curascript advising me that my prescriptions were being processed; that they would be sent to me soon; and that no action was required on my part. Given that they’d already told me the date to expect the delivery and it was still several days hence, I have no idea what this call was for – it served only to mystify and irritate me, particularly given that it could have been sent by email. Oh, right – Curascript has no online or email functionality.

Another few days later, I received a voicemail message (UUUGGGGHHH) indicating I needed to call Curascript right away. Which I did. Apparently, the date they had promised to deliver was too soon for Blue Cross to pay, so they had to push the date out a week. No big deal – except for the fact that they kept me on the phone for 15 minutes, asking questions, putting me on hold, making me repeat information I’d provided during my first call and during the IVR when I returned their call. Absolutely infuriating – again, particularly given the fact that a simple email with the new delivery date would have been sufficient notification.

I suppose it should come as no surprise that my prescriptions were not delivered on Friday as promised. I received a voicemail from FedEx at 5:17PM, advising that my parcel would be delivered on Saturday and a signature was required. Since I’d had the package directed to my office (and had advised each Curascript rep that I spoke with of this fact), there was no one there to sign for it. Which is just a perfect way to start a three-day weekend. I did check the FedEx tracking – and despite promising to deliver on Feb 18, Curascript didn’t get the package to FedEx until the evening of Feb 18. Yeah, let me put on my surprised face again…

Oh, and then I contacted Curascript on Saturday morning. Things did not go well…

Robot: Please tell us your phone number so we can look up your account.
Me: (enters number via keypad)
Robot: You entered number 415-###-####. Is that correct?
Me: Yes.
Robot: I’m sorry, I’m having trouble understanding you.
Me: YES!
Robot: I’m sorry, I’m having trouble understanding you.
Me: YEEEEEESSSSSSS!
Robot: I’m sorry, let me transfer you to an agent.
Robot: Our business hours are Monday through Friday, 9AM to 7PM and Saturdays, 9AM to 1PM. Please call back during business hours.

What is most infuriating of all is that I have no choice but to accept this level of incompetence and indifference. My only option for insurance at work is Blue Cross, so I can’t take my business elsewhere. And, to be honest, I’m one of the lucky ones – that is, I have insurance (even though it is provided by a for-profit insurer who is actively pursuing policies to prevent those with the most serious health conditions from obtaining treatment) and I have the stamina, wherewithal and persistence to demand and obtain satisfaction. But again, Blue Cross and Express Scripts surely calculate a drop-off in claims and payments (and therefore an increase in profit) by going after a population of insured that includes people who are too ill or simply too baffled to get the treatment to which they are entitled.

It’s times like this that I have some regret about being an atheist – the thought of people like John Cannon (Well Point CEO), George Paz (Express Scripts CEO) and Pam Kehaly (Anthem Blue Cross California president) spending eternity in the lake of fire is an appealing one.