We have a Medco prescription plan through Guardian. I hate it. Yes, it saves us a great deal of $$ but it is a tremendous hassle. We order our son's meds 3 months at a time. I KNOW to send it in WAAAAAAY ahead of time and I always have. Got an email a week and a half ago letting me know they had received it but got an autmated call today (10 days later)saying they couldn't fill it....no explanation. Now he only has 6 pills left and I will have to get a 1 month supply from the pharmacy for 3 times the amount. To top things off, I called to find out what the problem was...pressed 1 for "English" and got someone that DIDN'T speak english "very well". This was only after I spent 10 minutes getting through and automated directory. Anyone else out there have the same problem?
Mommy3 I feel your pain. We also have them for any long term medications. My DD is on a low dose birth control pill for her cramps. Insurance will pay for them. All good right? Wrong. They pay for them when ordered through Medco, getting 3 months worth at a time. Yes, it's a great deal only having to pay $15 for 3 months worth of medication but those people can be idiots. Every year when we have to renew this, it's a pain. They always refuse it saying it's for birth control. Well it's not. The Dr. will call, fax, etc everything they require. Get a message on answering machine saying prescription is on it's way. After 2 weeks, still nothing arrives. Call them and they say it can't be processed because they birth control isn't covered...GGGRRRR. So whole thing starts over again. We're still waiting..it's been 2 months since this was supposed to be renewed. Thank goodness the Dr. gave my DD some samples to last until the prescription came. Now catch this.....Last week I get an automated call from Medco asking if my shipping address was such and such. Press 1 if correct, etc. Well it was right. That got me to thinking. I went online and checked....guess what? They have the birth control pill prescription in MY NAME. I had a hysterectomy a couple of years ago. How funny is that? I give up...now I'll just wait and see if they come. Sorry so long but this one touched a nerve. Bren
Insurance doesn't cover birth control? :shock: Brilliant! That must be a huge money saver for the insurance companies! It must be so much cheaper to pay for pre-natal care, delivery, infant and child health care for 18 years, yeah, that's totally brilliant! What is the matter with insurance companies?
I worked for years in the ER, Nursing administration and as an open heart case auditor. The problem is that they do not have qualified medicl personnel making the decisions on what can and should be covered. A few years ago my dad had open heart surgery to repair leaky valves etc (pretty important stuff to fix huh?). 14 hours on the heart/lung machine. A few weeks later her received his hospital itemization for the tune of $250,000. The next day he got letters from medicare and his secondary saying that they did not feel the procedure was urgent (?!!?) and they would need to research to see if they were going to pay at all. Just the thing you need to hear while you are still trying to keep your chest sutures from opening up. I think we all have these kinds of stories....it's a shame very little can be done. When we complain, we are the ones who are being "difficult". Thanks for you sympathies!!
It's a racket. My kids' health insurance won't cover ADHD because it's a "behavioral problem." Well, so is every other mental disorder, but they cover most of those. Never mind that behavioral interventions for ADHD are pretty much useless without the medication in most cases.:evil: Maybe would should let Hillary have a chance to fix the system this time; it sure is broken! Snuff
As I said in my first post, I sometimes think a positive/negative experience often depends on who answers the telephone in customer service. If you press #1 for english you expect someone to understand you as well as you understanding them. That's the purpose in selceting one or the other in the first place. If we had only had a problem once...blow it off...but this has just become too much. Sadly, our plan offers no other options. I guess we should just be thankful we even have an option. I am usually one who tries to look at the glass as half full.
I am aware that the internet is often the way to go. Unfortunately, sometimes you HAVE to speak to a warm body.
