B
BostonsJ
Guest
Well I went around with the insurance company today. First you have to go through the machine that answers the phone. Then you get someone who tells you they can't help you and transfer you to someone else, all the while music blares in your ear. Then you get someone who actually listens to your problem but says I can't help you let me transfer you more music. Finally I get a person in pharmacy assistance who can help me and does.
When she heard they had yanked the prescription from my local specialty pharmacy insisting that it be sent to their pharmacy in Florida on the day it was to be refilled, she apologized and attempted to authorize one more refill. She also offered to assist me in setting up an account with the insurance company's pharmacy. OMG someone is trying to help me. She tells me she is going to call my pharmacy and authorize the refill and asks me to hold. It was too late, because the prescription had already been electronically transferred at their demand to the other pharmacy. She comes back and asks me, Maam are you totally out of your prescription? I said no I will be if I don't get it by Friday. She asks permission to put me on hold and and tells me she is on the phone with their pharmacy now.....More music...... Then, 30 minutes pass during which time she comes back several times to tell me she is trying to get this resolved quickly, that generally it takes 3-5 days........more music........
Finally 45 minutes after I reached this particular very helpful person she comes back to tell me they found my prescription but they can't refill it until tomorrow, get this,,,,,, because their computers are locked on new prescriptions for 48 hours. OMG what is that? Now I am directed to call the pharmacy tomorrow to follow up. I am thrilled that I will have my prescription by the weekend but totally fed up that an insurance company treats people like this. They never forget to take my monthly payment! I wasn't buying socks online at Target, I am trying to get a vital prescription which seems to be in never never land for 48 hours. I couldn't be upset with this representative though, she was truly very helpful and got me all registered at the new pharmacy.
OK now I am 50 percent there, I hope, I know they are going to fill my prescription and next day UPS it from Florida. Makes no sense to me when there is a pharmacy 20 miles away that was doing just fine in getting me my prescription. So now I have to call the pharmacy because the co-pay is so huge on this drug that it makes it pretty much unaffordable without another co-insurance. So the drug company has a program where they pay most of your co-pay. My former pharmacy is the one that got me set up and told me about this program on my first month on this drug.
Yesterday when I called this new pharmacy the moron who answered the phone had no clue about this co-insurance by the drug company. So now my worry is they won't accept this co-insurance and I'm going to have a phenominal co-pay when I call tomorrow. So, I was going to have them call and talk to an insurance rep at the drug company trying to get this set up ahead of time rather than run into a problem tomorrow.
Today I lucked out. The person who answered the phone at the new pharmacy told me they do accept this co-insurance and that they understand how to bill it. She told me she was going to call me but didn't have a phone number for me.....eeeeegggggaddddds so I give her two numbers at which to reach me. She told me my prescription had not popped out of the computer yet but promised she would watch it and call me tomorrow. OMG I actually got some help at the new pharmacy from someone who knew what they were talking about. So I reminded her about the temperature control on this medication and she told me not to worry they pack in dry ice for the long trip from Florida overnight to CO. This drug has to be maintained between 35 and 45 degrees F. So I worry that it will make it here still good. She assured me it would. Jeesssssshhhh my insurance company may be saving 20.00 a month but what they have put me through has been incredible.
The worst part is that my doctor told me that soon, the insurance will refuse to pay for the drugs at the current levels. He said the only reason doctors taper this drug down after 3 months is because the insurance company refusees to pay for them at the higher dose. It makes me furious that doctors are no longer treating patients, the insurance companies are.
Tomorrow I'll find out at what level they approve this drug. If they taper me, then I have to call the doctor and get them working on this for me to fight for what he really wants me to be taking!
I know I'm not alone, this is something that every single person with insurance goes through. It is insanity.
My former pharmacy did everything for me. They got the prescription, they called me and told me to call a 1-800 number and talk to the drug company insurance reps in order to reduce my co-pay. They even gave me the card for the co-insurance which they maintain on hand for new patients on this therapy. Within one hour I was all approved and my co-pay reduced by 3/4, and my prescription was filled and an appointment set for the pharmacist to teach me to inject myself. They were so helpful, each month they would call me and tell me it was time to refill I never had to call them. What a sin that we are at the mercy of the insurance companies for medical care.
I am going to have to be right on top of this other pharmacy I fear. Hopefully I have set the wheels in motion and finally this is all set. If you hear a scream from CO tomorrow you will know why.
When she heard they had yanked the prescription from my local specialty pharmacy insisting that it be sent to their pharmacy in Florida on the day it was to be refilled, she apologized and attempted to authorize one more refill. She also offered to assist me in setting up an account with the insurance company's pharmacy. OMG someone is trying to help me. She tells me she is going to call my pharmacy and authorize the refill and asks me to hold. It was too late, because the prescription had already been electronically transferred at their demand to the other pharmacy. She comes back and asks me, Maam are you totally out of your prescription? I said no I will be if I don't get it by Friday. She asks permission to put me on hold and and tells me she is on the phone with their pharmacy now.....More music...... Then, 30 minutes pass during which time she comes back several times to tell me she is trying to get this resolved quickly, that generally it takes 3-5 days........more music........
Finally 45 minutes after I reached this particular very helpful person she comes back to tell me they found my prescription but they can't refill it until tomorrow, get this,,,,,, because their computers are locked on new prescriptions for 48 hours. OMG what is that? Now I am directed to call the pharmacy tomorrow to follow up. I am thrilled that I will have my prescription by the weekend but totally fed up that an insurance company treats people like this. They never forget to take my monthly payment! I wasn't buying socks online at Target, I am trying to get a vital prescription which seems to be in never never land for 48 hours. I couldn't be upset with this representative though, she was truly very helpful and got me all registered at the new pharmacy.
OK now I am 50 percent there, I hope, I know they are going to fill my prescription and next day UPS it from Florida. Makes no sense to me when there is a pharmacy 20 miles away that was doing just fine in getting me my prescription. So now I have to call the pharmacy because the co-pay is so huge on this drug that it makes it pretty much unaffordable without another co-insurance. So the drug company has a program where they pay most of your co-pay. My former pharmacy is the one that got me set up and told me about this program on my first month on this drug.
Yesterday when I called this new pharmacy the moron who answered the phone had no clue about this co-insurance by the drug company. So now my worry is they won't accept this co-insurance and I'm going to have a phenominal co-pay when I call tomorrow. So, I was going to have them call and talk to an insurance rep at the drug company trying to get this set up ahead of time rather than run into a problem tomorrow.
Today I lucked out. The person who answered the phone at the new pharmacy told me they do accept this co-insurance and that they understand how to bill it. She told me she was going to call me but didn't have a phone number for me.....eeeeegggggaddddds so I give her two numbers at which to reach me. She told me my prescription had not popped out of the computer yet but promised she would watch it and call me tomorrow. OMG I actually got some help at the new pharmacy from someone who knew what they were talking about. So I reminded her about the temperature control on this medication and she told me not to worry they pack in dry ice for the long trip from Florida overnight to CO. This drug has to be maintained between 35 and 45 degrees F. So I worry that it will make it here still good. She assured me it would. Jeesssssshhhh my insurance company may be saving 20.00 a month but what they have put me through has been incredible.
The worst part is that my doctor told me that soon, the insurance will refuse to pay for the drugs at the current levels. He said the only reason doctors taper this drug down after 3 months is because the insurance company refusees to pay for them at the higher dose. It makes me furious that doctors are no longer treating patients, the insurance companies are.
Tomorrow I'll find out at what level they approve this drug. If they taper me, then I have to call the doctor and get them working on this for me to fight for what he really wants me to be taking!
I know I'm not alone, this is something that every single person with insurance goes through. It is insanity.
My former pharmacy did everything for me. They got the prescription, they called me and told me to call a 1-800 number and talk to the drug company insurance reps in order to reduce my co-pay. They even gave me the card for the co-insurance which they maintain on hand for new patients on this therapy. Within one hour I was all approved and my co-pay reduced by 3/4, and my prescription was filled and an appointment set for the pharmacist to teach me to inject myself. They were so helpful, each month they would call me and tell me it was time to refill I never had to call them. What a sin that we are at the mercy of the insurance companies for medical care.
I am going to have to be right on top of this other pharmacy I fear. Hopefully I have set the wheels in motion and finally this is all set. If you hear a scream from CO tomorrow you will know why.
hone