My mother has Medicare Part D, which is the plan that pays for prescriptions. Turns out, we were paying full price for her prescriptions all year last year, even though her pharmacy had her Part D information. This was caught by the pharmacist in November. The pharmacy reimbursed us directly for three months of prescriptions and we filed a claim to the insurance company for prescriptions purchased from January through July.
Turns out that you only have three months from date of purchase to file a claim according to the insurance company.
This adds up to around $1700 of over-payment that won’t be covered.
Do we have any recourse, or is mom screwed? Can we appeal to the insurance company? Can we hold the pharmacy liable?
I realize that we should have known, but we didn’t. She takes really expensive medications for Alzheimers. We figured the high cost was just the limits of her policy. I can accept that and learn this painful lesson if there is no recourse. But I don’t want to give up prematurely if there is still means to get her money back.