{"id":8144,"date":"2016-06-13T16:44:08","date_gmt":"2016-06-13T20:44:08","guid":{"rendered":"http:\/\/www.mdcthereporter.com\/?p=8144"},"modified":"2021-05-14T13:29:32","modified_gmt":"2021-05-14T17:29:32","slug":"health-insurance-companies-are-acting-as-doctors","status":"publish","type":"post","link":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/","title":{"rendered":"Health Insurance Companies Are Acting As Doctors"},"content":{"rendered":"

It was a Friday afternoon at a busy pharmacy in Miami. People walked in with their insurance cards and about half of them walked out without their medications. This was the case for a middle aged man I met while working at a pharmacy ten minutes away from Miami International Airport<\/span><\/a>. He was picking up crucial heart medications for his wife, who he claims had open heart surgery recently. <\/span><\/p>\n

When I pulled up her profile in the system, I saw that all three medications my patient needed had been rejected by her insurance, showing up as a \u201cPrior Authorization\u201d error. Given the grave circumstances of this person\u2019s health, I decided to call her insurance provider to try to get an override on her medications. <\/span><\/p>\n

I spoke with three different agents but they all told me the same thing, the patient\u2019s primary health care provider would have to call them to justify the use of these medications (which, according to the husband the medications should have been covered anyway) before the insurance starts paying for them. <\/span><\/p>\n

The problem with the explanation I was given was that the medications being rejected by the insurance company were not prescribed by the patient\u2019s primary doctor. As a matter of fact, they were prescribed by two separate specialists who treated the patient at a hospital, and both were unavailable at the time as well. I didn\u2019t know how to tell the man that his wife\u2019s medications weren\u2019t available to be picked up unless he paid for them, but that is what he had to do. <\/span><\/p>\n

In the year that I\u2019ve been working at a pharmacy, I\u2019ve observed cases like the one previously mentioned over and over again. It\u2019s become clear to me that \u201cPrior Authorization\u201d rejections are not the exception, they are the rule. <\/span><\/p>\n

People who are prescribed multiple medications run into this problem very often. For almost every three medications I see being prescribed, one of them is rejected by the patient\u2019s health insurance. <\/span><\/p>\n

As worded by a pharmacist I work with, who asked to remain anonymous, \u201cHealth insurance providers act like doctors. They decide how much medicine a patient needs, how often the patient can take it and what justifies the patient taking these medications. It\u2019s ludicrous.\u201d<\/span><\/p>\n

Health insurance providers overstep their boundaries when it comes to people\u2019s health. Even though regulations have been passed prohibiting health providers from dropping people with pre-existing conditions, it is just a drop in the ocean when it comes to making sure everyone gets the medical care they need.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

It was a Friday afternoon at a busy pharmacy in Miami. People walked in with their insurance cards and about half of them walked out without their medications. This was the case for a middle aged man I met while working at a pharmacy ten minutes away from Miami International Airport. He was picking up […]<\/p>\n","protected":false},"author":302,"featured_media":14041,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","tdm_status":"","tdm_grid_status":"","footnotes":""},"categories":[13],"tags":[384,1022],"class_list":{"0":"post-8144","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-forum","8":"tag-insurance","9":"tag-healthcare"},"yoast_head":"\nHealth Insurance Companies Are Acting As Doctors<\/title>\n<meta name=\"description\" content=\"Gabriel Exposito writes about how health insurance companies are making it difficult for patients to receive their medication.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Health Insurance Companies Are Acting As Doctors\" \/>\n<meta property=\"og:description\" content=\"Gabriel Exposito writes about how health insurance companies are making it difficult for patients to receive their medication.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/\" \/>\n<meta property=\"og:site_name\" content=\"The Reporter: The Student Newspaper at Miami Dade College\" \/>\n<meta property=\"article:published_time\" content=\"2016-06-13T20:44:08+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-05-14T17:29:32+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2018\/08\/forum_header-800x534.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"800\" \/>\n\t<meta property=\"og:image:height\" content=\"534\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Gabriel Exposito\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Gabriel Exposito\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/\"},\"author\":{\"name\":\"Gabriel Exposito\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#\\\/schema\\\/person\\\/c66652ca690364aeffac436072e8f531\"},\"headline\":\"Health Insurance Companies Are Acting As Doctors\",\"datePublished\":\"2016-06-13T20:44:08+00:00\",\"dateModified\":\"2021-05-14T17:29:32+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/\"},\"wordCount\":441,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/wp-content\\\/uploads\\\/2018\\\/08\\\/forum_header-800x534.jpg\",\"keywords\":[\"Insurance\",\"healthcare\"],\"articleSection\":[\"Forum\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/\",\"url\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/\",\"name\":\"Health Insurance Companies Are Acting As Doctors\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/wp-content\\\/uploads\\\/2018\\\/08\\\/forum_header-800x534.jpg\",\"datePublished\":\"2016-06-13T20:44:08+00:00\",\"dateModified\":\"2021-05-14T17:29:32+00:00\",\"description\":\"Gabriel Exposito writes about how health insurance companies are making it difficult for patients to receive their medication.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/#primaryimage\",\"url\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/wp-content\\\/uploads\\\/2018\\\/08\\\/forum_header-800x534.jpg\",\"contentUrl\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/wp-content\\\/uploads\\\/2018\\\/08\\\/forum_header-800x534.jpg\",\"width\":800,\"height\":534},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/health-insurance-companies-are-acting-as-doctors\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Health Insurance Companies Are Acting As Doctors\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#website\",\"url\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/\",\"name\":\"The Reporter: The Student Newspaper at Miami Dade College\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#organization\",\"name\":\"MDC The Reporter\",\"url\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/mdcthereporter.com\\\/\\\/wp-content\\\/uploads\\\/2016\\\/08\\\/R_reporter_logo.png\",\"contentUrl\":\"https:\\\/\\\/mdcthereporter.com\\\/\\\/wp-content\\\/uploads\\\/2016\\\/08\\\/R_reporter_logo.png\",\"width\":315,\"height\":309,\"caption\":\"MDC The Reporter\"},\"image\":{\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/#\\\/schema\\\/person\\\/c66652ca690364aeffac436072e8f531\",\"name\":\"Gabriel Exposito\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/wp-content\\\/uploads\\\/2016\\\/09\\\/R_reporter_logo-1-1-125x125.png\",\"url\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/wp-content\\\/uploads\\\/2016\\\/09\\\/R_reporter_logo-1-1-125x125.png\",\"contentUrl\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/wp-content\\\/uploads\\\/2016\\\/09\\\/R_reporter_logo-1-1-125x125.png\",\"caption\":\"Gabriel Exposito\"},\"url\":\"https:\\\/\\\/mdcthereporter.com\\\/staging\\\/8357\\\/author\\\/gabriel-exposito\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Health Insurance Companies Are Acting As Doctors","description":"Gabriel Exposito writes about how health insurance companies are making it difficult for patients to receive their medication.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/","og_locale":"en_US","og_type":"article","og_title":"Health Insurance Companies Are Acting As Doctors","og_description":"Gabriel Exposito writes about how health insurance companies are making it difficult for patients to receive their medication.","og_url":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/","og_site_name":"The Reporter: The Student Newspaper at Miami Dade College","article_published_time":"2016-06-13T20:44:08+00:00","article_modified_time":"2021-05-14T17:29:32+00:00","og_image":[{"width":800,"height":534,"url":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2018\/08\/forum_header-800x534.jpg","type":"image\/jpeg"}],"author":"Gabriel Exposito","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Gabriel Exposito","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/#article","isPartOf":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/"},"author":{"name":"Gabriel Exposito","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#\/schema\/person\/c66652ca690364aeffac436072e8f531"},"headline":"Health Insurance Companies Are Acting As Doctors","datePublished":"2016-06-13T20:44:08+00:00","dateModified":"2021-05-14T17:29:32+00:00","mainEntityOfPage":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/"},"wordCount":441,"commentCount":0,"publisher":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#organization"},"image":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/#primaryimage"},"thumbnailUrl":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2018\/08\/forum_header-800x534.jpg","keywords":["Insurance","healthcare"],"articleSection":["Forum"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/","url":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/","name":"Health Insurance Companies Are Acting As Doctors","isPartOf":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#website"},"primaryImageOfPage":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/#primaryimage"},"image":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/#primaryimage"},"thumbnailUrl":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2018\/08\/forum_header-800x534.jpg","datePublished":"2016-06-13T20:44:08+00:00","dateModified":"2021-05-14T17:29:32+00:00","description":"Gabriel Exposito writes about how health insurance companies are making it difficult for patients to receive their medication.","breadcrumb":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/#primaryimage","url":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2018\/08\/forum_header-800x534.jpg","contentUrl":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2018\/08\/forum_header-800x534.jpg","width":800,"height":534},{"@type":"BreadcrumbList","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/health-insurance-companies-are-acting-as-doctors\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/mdcthereporter.com\/staging\/8357\/"},{"@type":"ListItem","position":2,"name":"Health Insurance Companies Are Acting As Doctors"}]},{"@type":"WebSite","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#website","url":"https:\/\/mdcthereporter.com\/staging\/8357\/","name":"The Reporter: The Student Newspaper at Miami Dade College","description":"","publisher":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/mdcthereporter.com\/staging\/8357\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#organization","name":"MDC The Reporter","url":"https:\/\/mdcthereporter.com\/staging\/8357\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#\/schema\/logo\/image\/","url":"https:\/\/mdcthereporter.com\/\/wp-content\/uploads\/2016\/08\/R_reporter_logo.png","contentUrl":"https:\/\/mdcthereporter.com\/\/wp-content\/uploads\/2016\/08\/R_reporter_logo.png","width":315,"height":309,"caption":"MDC The Reporter"},"image":{"@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/#\/schema\/person\/c66652ca690364aeffac436072e8f531","name":"Gabriel Exposito","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2016\/09\/R_reporter_logo-1-1-125x125.png","url":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2016\/09\/R_reporter_logo-1-1-125x125.png","contentUrl":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-content\/uploads\/2016\/09\/R_reporter_logo-1-1-125x125.png","caption":"Gabriel Exposito"},"url":"https:\/\/mdcthereporter.com\/staging\/8357\/author\/gabriel-exposito\/"}]}},"cc_featured_image_caption":{"caption_text":"","source_text":"","source_url":""},"_links":{"self":[{"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/posts\/8144","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/users\/302"}],"replies":[{"embeddable":true,"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/comments?post=8144"}],"version-history":[{"count":0,"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/posts\/8144\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/media\/14041"}],"wp:attachment":[{"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/media?parent=8144"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/categories?post=8144"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mdcthereporter.com\/staging\/8357\/wp-json\/wp\/v2\/tags?post=8144"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}