Prescription Insurance Blues

My current employer recently changed the way it funds its employee health insurance policies--and its prescription plan.

I haven't been to a doctor since the change, which took place on the first of last month.  However, yesterday I went to pick up a refill for my estrogen (Premarin) prescription.

The last time it was refilled, in August, I received a 90-day supply for a co-pay or $45.  That had been the cost almost from the time I had my surgery, about five years ago.  Before that, I was paying ten dollars for a 30-day supply.

When I went to the Callen-Lorde pharmacy center, the clerk told me that, according to the current plan, I am allowed only 30 days at a time.

That, in and of itself, would have been nothing more than an inconvenience. But the next bit of news she gave me could have a real impact on my life:  It's now $81.24 for that 30-day supply.

When I called Express Scripts, who manages the plan, the person kept on saying "I hear you, I hear you."  When I asked for an explanation, he said, "Well, it costs more now."  Well, duh.  He said I'd have to contact the insurance company, whose name he didn't have.  

"That price is for in-person pick up," he said.  "If you want it mailed to you, you can get a 90-day supply for $243.72."  Now, the highly atrophied part of my brain that does math couldn't make the calculation on the spot, but it didn't sound like a discount--and, of course, it isn't.  

"So how did the price more than quadruple in the three months since I last got my prescription.  Did cows become an endangered species or something?"
(Premarin comes from pregnant mares.) He repeated, "It costs more now."  Then he gave an ever-so-helpful suggestion:  "You should call the insurance company."

That office--or, more precisely, the office of the person who administers the plan for my employer--was closed by that time.  I left two voice mail messages yesterday: one in the morning, one in the afternoon. The second time I called, I was switched to the main number, where I was told the person I needed to talk to was "out to lunch".  On Friday, you know what that means.

I hope to hear from her on Monday.  How, exactly, does a drug I need go from $45 for a three-month supply to $81.24 for one month?

A Face of More Change?

I've got to get someone to photograph me. Perhaps that sounds vain, but I'm thinking that it might be important.

What got me to thinking that way? Well, when I was walking to my aprtment, I bumped into Sara and Dee. I hadn't seen Sara since some time around the holidays, and it'd been even longer since I'd seen Dee. I think of Sara as a kind of Mrs. Dalloway figure, and Dee as her lover. However, theirs isn't the sort of relationship that lovers or even partners have. As far as I can tell, they're just two people who love and need each other, for better and worse.

Anyway, they both remarked that my face has changed over the last few months. They're not the first people who've told me that. Jay also said it a couple of weeks ago; so did Beth, a prof in my department. As far as I know, Jay and Beth don't know each other, and neither of them knows Sara or Dee. But their comments echoed each others': They all said my face has "softened" and "looks more feminine." I hope they're right. Something seems to have changed, and I hope they all perceived it accurately.

If they're right, I can't help but to wonder whether it has anything to do with the surgery. Of course, Marci didn't operate on my face, but if nothing else, her work has helped me to feel more confident in who I am. Perhaps that's what's showing in my face.

I have another, slightly more scientific explanaton. My change may also have to do with the fact that I no longer have my testicular glands. So, my body has not been producing testosterone and I have not had to take Spironolactone to counter it. I can't help but to think that the fact that there isn't any testosterone to counter or suppress has to be changing something in my body. And, of course, the Premarin I've been taking since I started my transition is probably having more effect on me than it did when I had to neutralize my testosterone.

I'm neither a doctor nor a scientist, so take that explanation for what it's worth. I just hope my friends' and colleagues' observations are accurate.