|Pharmacy benefits: You're doing it wrong
||[May. 22nd, 2012|01:17 pm]
Today I went in to my local pharmacy that I've been using for years to fill a prescription. It's a kind of prescription that requires a hard-copy prescription every month so I cannot use the mail order pharmacy that my health care plan has since they will not fill a 90 day supply of it.
I turned in the prescription at the desk and a few minutes later the pharmacist called me back to the desk. She looked distraught.
"I'm sorry," she said. "But I can't fill this."
"Do you not have it in stock?"
"We have it in stock, but... The fact of the matter is that the price of this medication, even in generic, has gone up for us to procure, and your insurance's reimbursement is too far under our cost. So basically, it would cost us too much money to fill this. I'm sorry."
She handed the prescription back to me and wished me well.
Think about this: I have been told multiple times that the insurance I have, while not the best, is considered to be very good insurance.
Wow. That's really screwed up.
If the pharmacy in question is not Costco, and you have a Costco membership, it may be worth trying there.
I hope you're able to find a pharmacy that will fill your prescription.
Damn. I hope there is a way to get around that.
My prescriptions cost more then my very good insurance covers. I pay the difference. Always have.
Unless you can't cover the difference, that... makes no sense.
Ugh. This makes me appreciate my oft-maligned HMO. I may have to pay more than the usual co-pay for off-formulary medications, but they do cover it to a point.
There should be some way for you to pay at least part of the difference. Does your insurance company have any suggestions?
While it galls me to play this game with them, you need your meds. Would they accept a larger copay from you to allow you to get your meds?
Also, feel free to e-mail me information and I'll see what I can find out, like if there's something that would do the same job for less money or better reimbursement.