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I have been dealing with getting approval for a prescription medication that is a covered benefit on our insurance policy. However, upon taking this to the pharmacy, I'm told they get a rejected "Not Covered Benefit" response and the entire cost of this very expensive medication will have to come out of my pocket. 

Rather than getting mad at the pharmacy, I tell them I will follow up with the insurance company. And so my twisted quest begins.

I call the insurance company, speak to the first rep who tells me its covered but she too gets a not covered when trying to find out what the co-pay will be. I now call and speak to four different departments.  Every customer service rep I speak with admits it is covered on our formulary. HOWEVER, after them saying that a form needed to be input into the system so we only have to pay the co-pay and not the outrageous price per pill, we're still waiting.

Then after 9 calls and 2 1/2 weeks, I called to check on the status only to discover they NOW need a preauthorization from the doctor's office to make sure its medically necessary.  Excuse me, I HAVE A PRESCRIPTION. Doesn't that make it medically necessary? Apparently not.

OK, I call the doctor's office, speak to his nurse who calls the insurance company, faxes them the form and wait, again, for another 5 days.

Call in again, speak to customer service who tells me first they don't see the preauthorization. So I basically go through this twisted tale of how long this has been going on and how frustrated I am (not with her) with the entire system which I am sure is designed to make someone give up so the insurance company does NOT have to pay for the coverage I'm paying for.

Feeling compassion for my frustration, she calls the appropriate department only to discover they have the preauthorization and they're working on it. Then says it takes 24-48 hours to get final approval. Final approval??? From Who???? 

Final approval remains a mystery. However, the customer service rep again takes pity on me and even though its already been over 24 hours, she will check on it in the morning AND IF she is successful, she will call me.

I am not hopeful but vow to call in AGAIN tomorrow. afternoon to speak to yet another customer service rep because you never get the same one twice AND they don't have direct lines so you can call back and speak to the same one. UGH!!!!