RX, Pharmacy, Insurance bullshit yesterday...

...yesterday I had to have RXs filled. So, of course, I went to the pharmacy.

I had one RX for 30 pills of one med. The insurance covered only 15 pills every 30 days for that RX ~~ which is OK since I would have gone back for the rest of the pills due me since the MD put down 30 pills on the RX and that could not be changed. Guess what? The pharmacy computer would not take an order in the amount of only 15 pills on that RX...so I ended up paying out of pocket for the entire FN 30 pills!!!!! No partial payment credited to me for the 15 pills that were covered ~~ it was either 15 pills covered by insurance or I pay for it all!!!!

:mad:

What totall bullshit ~~ in the drug store at 6:00 PM and I had been to urgent care for nearly 6 hours and just wanted my meds and to get the hell home. So the pharmacy clerk says ~~ call my insurance company and complain...yada, yada. About what? That the computer at the pharmacy would not take a lesser number of pills in the RX order so the insurance covered it???

I did not know whether to laugh or to FN cry!

Edit for typo

I had an RX for 100 pills. My insurance pays for a 34 day supply which is = 102 pills.

Being their computer is set-up for a 30 day supply and that is it (90 pills) they gave me 10 pills less that what the RX was written for.

I ended up filing a complaint with the Better Business Bureau. It took awhile but I finally got the rest of my RX and I no longer do business with that pharmacy.

I realize your situation is different but maybe the Better Business Bureau can help? :shrug:

I'm sorry to hear of your frustration and anger. You don't need it, especially after being in an urgent care center for 6 hrs.! Get well soon! :hug:

:dem:

...I never thought of the BBB...since it was the computer that would not allow the number of pills to be changed, the pharmacy is the one who did the damage by making my insurance deny the coverage.

Somehow, tho, I have to think that the pharmacy and the insurance company make things like this happen!

It was their "new" computer program at work, not them (oh no, not THEM). FUCK THEM.

You can file a complaint online with the BBB btw. It worked like a charm in my case and wow was I ever angry as the pills I had were after major surgery and I really needed them!

It is a lot easier to blame a machine rather than the operator!

:grr:

Take care and best of luck!!

...thanks again and it does seem like there is a new scam everyday! :hi:

from my doctor, which I was going to have filled by mail. The 90 day supply was for 360 pills and would cost me $5. She also gave me a prescription for a 10 day supply, 40 pills to cover me until the I received my mail order supply.

I went the pharmacy & told them not to use my insurance (if I had the 10 day supply using insurance-insurance would not cover the 90 day supply). When I went to pay for it, the cost was $77. I refused, took back the prescription & went to another pharmacy. The cost there was $66, which I didn't want to pay. The clerk asked me if I was a AAA member, I am. The cost using my AAA membership was $11.

My mom has a prescription that using her insurance would be about $65, but she uses a prescription savings card (free, no cost card) and the cost is $11. Our county health department also issues no cost prescription savings cards, and there is no income requirement to receive these free cards.

I'm sorry you had to pay out of pocket, but the clerk should have had some idea to lessen the out of pocket expense.

I am hoping that is the card you are referring to since I just got my new membership card!

:hi:

assume it's a national program. One of the many perks they have.

anything like that. Thanks....z

And for impacting the bottom line of your "insurance" company.

And, by extension, reducing the CEO's totally deserved, certainly-not-rapacious bonus.

Need I add the :sarcasm: tag?

There has to be a way to over-ride the computer. Not all prescriptions fall into a nice compartmentalized process. File a complaint with the state.

http://www.pharmacy.ca.gov/consumers/complaint_info.shtml#prescription

That's for California, anyone else can just Google pharmacy + complaints.

:hi:

...guess what I found this AM when I took my meds?

The FN pharmacy only gave me 15 pills AND the label print out is for 15 and they STILL made me pay for it even tho they told me that if the MD had written for only 15 it would have been covered AND the computer would only let them dispense for 15!

I had not noticed until now...and, boy, I am telling ya, I am gonna go back there and SCREAM bloody murder today!

:grr:

And consider buying through an online Canadian pharmacy, I just did this last month, and saved a bundle. What would have cost $400 for name-brand (90 day supply), and $300 for generic (less effective, in my case) cost only $86, delivered, for name-brand.