Yay! 
YAY! Send some of that good mojo my way!
Nope. These are all ridiculous guidelines set up by the insurance company and enforced by dog-fucking CVS Express Scripts. There is absolutely no reason that you could not get the medication from anyone who sells it; all of this bullshit you’ve had to go through is an attempt to control costs. These attempts always negatively impact the patients who are supposed to be treated by health insurance.
Exactly. UHC stopped covering generic Vicodin out of the clear blue sky about a year ago and the first I heard of it was when I couldn’t get it at CVS. So I call, and the bot on the phone says yes, it isn’t covered anymore. Uh, pain medication? Finally she admits that I can get generic Norco, which is almost exactly the same thing, but apparently cheaper. So, jerking a person with chronic pain around to save a penny or two? Yeah, that’s UnitedHealthcare, may they be nuked from space.
[quote=“GrumpyBunny, post:63, topic:742376”]
I think you’re missing the context of what I said. I had mentioned that it was being covered 100% this time while in the past I had always had a 50% copay. So they’re paying more now, which is hardly a cost saving measure.
Here’s the relevant context:
I’m not defending the insurance company for their overall behavior, just clarifying what I meant in that quote.
Let me add another pet peeve. Since it’s the beginning of the year, I have about twenty notices from insurance companies that particular medications are not going to be covered. This requires me to do one of the following:
See if an alternative is available, call the patient to see if they agree to it, have either the patient or my staff check to see if the alternative is on the new formulary, and if so prescribe it.
Go through all of the patient’s old records to see what they have tried in the past and why it was stopped. File an appeal for coverage of the original medication with forms that are different for each company and remembering which ones require online appeals and which require a peer-to-peer telephone call (for which I usually have to have them call me back at their convenience) and hope for authorization.
Try to get free medications from the manufacturer which requires the patient to fill out an extensive financial release form which they often either don’t want to do or have difficulty doing.
Try to get samples from the manufacturer to give to the patient to cover the time until the above is worked out.
If samples are not available, arrange an alternative treatment plan until the medications arrive and make sure the patient understands the new regimen.
After all of this and getting a letter from the insurance saying that they have agreed to cover the nonformulary medication for a year get an irate call from the patient because although the medication is “covered” that doesn’t mean the price is affordable and instead of paying $30 a month, the patient now owes $400 a month.
Start over at step one.
NO!!!
Health insurance companies do NOT treat anybody – Doctors, Nurses, etc. do that.
Despite all their attempts to confuse the two, Insurance Companies do nothing to treat sick & injured people. They are just parasites on the health care system, ripping off a big share of the money for their so-called ‘services’. The health care system could function quite well without them – in fact, it already does so in many countries.
This.
My broker told me that notices had been sent to providers that Acro would no longer be shipping this medication and that an alternative provider would have to be used. But as you say, that office is probably swamped with such things at the beginning of the year. And anyway, shouldn’t I have also been notified? That way I could have started the whole bureaucratic process immediately rather than when I was ready for a refill.
I know, right? There’s a health insurance scam operation that advertises on local tv here.
“Health Care Reform is available NOW”. Um, no. One can’t purchase health care reform. The whole campaign is idiotic. I wonder who their target market is, other than idiots?
I received a letter from Blue Cross today stating that I’m approved to receive the medicine from Walgreens Specialty Pharmacy for one year. I’m not sure what the copay will be or if there even is one. I’m going to contact my broker to see what she knows.
I’m kind of hoping that I can keep off the weight I lost, but since I started eating again I’ve been ravenous.
The saga continues. The 3 months are up so it was time for a refill. Since the medicine is prescribed to be used “as needed” I haven’t actually used it all up but I figured that I’ll refill it now. My thinking being that I’d like to get as far ahead on it as I can (expiration dates allowing) so that the next time everything goes fubar I’ll have a number of weeks backup while it gets straightened out.
So I called for a refill and was told that I can get it now and that they could send me a month’s worth with a copay. That’s not as generous as the last time (3 months with no copay) but I guess they did that to make up for screwing things up so badly and one month with a copay is the norm.
One month’s worth is 3 vials; 10 days per vial. The medicine arrived today - 15 vials of it. That’s 5 months worth. These people are idiots. The expiration dates are all 12/2016 and I’ll use it eventually and it certainly gives me a feeling of security for now, but I just hope that they’re not going to try to hit my checking account for a $900 copay all at once. I’ll try calling them tomorrow but I probably won’t be able to get anyone till Monday.
CVS and Express Scripts are 2 completely different companies.
Expiration dates are set at “worst case” scenarios:
Left on a south-facing widow sill in the bathroom beside the shower. Above the radiator. In the Sahara.
I’m not concerned about the expiration date (although any extended time not refrigerated would destroy it much sooner). I’ll likely use it all before December so that’s not an issue.
What I’m not sure about is if I can keep an amount of prescription medicine that is obviously a mistake. When I ordered the refill they emphasized that it can’t be returned so if I did send it back they’d likely just dispose of it.
I think I sort of know what happened. The last time, they said that they were sending me 3 months worth and I correctly received 9 vials. However, the invoice showed a quantity of 45. I figured that, since each vial is 5 ml of liquid, and 5 * 9 = 45, the quantity on the invoice was in milliliters. This time, the invoice shows a quantity of 15 which, if consistent with the previous order, means 15 ml or 3 vials which is what they said they were sending me. I’m guessing that whoever packed the order saw the quantity of 15 and sent me 15 vials rather than 15 ml.
Maybe the day has come where we all need to bring a lawyer with us to the doctor’s office, for the amount we pay in medical costs, lawyer’s fees seem small …
I should have started a new thread. Everyone is responding to old posts. :smack:
I just spoke to the pharmacy. It was an error on their part and I can keep all 5 months’ worth but I only have to pay the copay for the 1 months’ worth that they were supposed to ship.
So I won the lottery on this and it’s their loss.