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Discussion Starter #1
My prescription by mail place keeps changing my husbands prescriptions. This can't be right, can it? How can they possibly be allowed to do that?

For instance I sent in for a 90 day supply of syringes (we HAVE to get long term prescriptions filled through the mail - don't have a choice in the matter). The prescription was written for 450 syringes and they changed it to 360.

I don't know where they get off taking on the authority that he only needs 4 shots of insulin per day and therefore only 4 syringes per day. DH needs a minimum of 4 a day, sometimes 5 or 6.

They make me so mad. They won't give me a straight answer about it when I ask them. They just tell me have the prescription written again, mail it in with another $45 co-pay and we'll fill it. I asked them, "But how do I know you won't change it again?"

:flame:

Then I figured out that they are charging nearly twice as much for DH's cholesterol meds and other meds compared to retail pharmacies. Since our co-pay is based on the cost of meds it means we may MORE money for prescriptions from the mail in place. Now I thought they weren't meant to save the company and us money - BUT NO!

I'm wondering if I should let the plan administrators know that this mail in pharmacy is actually more expensive than retail. But will they either care?

I notified my medical insurance of a fraudulant claim that they had paid where someone had billed them for services that I DID NOT receive and last time I checked nothing had been done to get their money returned. They probably figure it isn't worth there time but it should be.

Okay, rant over. :hobbyhors
 

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I asked my doctor to write me 60 day prescriptions in may as I would be gone for a month in June and didn't want to mess with trying to refill prescriptions while travelling out of state.
My supplier is Walgreens. Because I live in 2 towns and the insurance won't approve a refill till I am down to 3 days doses, I had to try to fill them in 2 different towns.
I told each pharmacy clerk I would be out of town till 7/1/07. That's why I had a prescription for 60.
Each time I picked up, I was given a 30 day supply. The pharmacy in Palm Beach County, when this happened, was happy to call the insurance and get a "vacation override". There was a woman travelling to germany for 2 months next to me going thru the same thing.
When I picked up in Highlands County, the Walgreens REFUSED to call the insurance company for a vacation override. When I got back to Palm Beach County I had walgreens give me the fill for the second month's supllies.
I take high blood pressure meds and sometimes I swear the pharmacies are TRYING to drive us to a stroke.

OP- can you have your doctor write a leyter to the pharmacy that his diabetes is not stable at 4x daily doses, and it would be medically necessary for him, to avoid ER fees, to have the extra 2 syringes a day?
 

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It is NOT true that mail order will save you money. I have an HDHP/HSA - $2200 deductible. I get a phone call from the insurance company asking me if I would consider mail order. I said the daughter was in college and mail order made it difficult. And that I wasn't convinced it cost less. She asks if she can quote it, I say go ahead. Sure enough, cheaper to go to the pharmacy.

They can dispense what the bean counters have deemed 'the most cost effective dosage'. BUT they should send the rest after so many days, e.g. you've used up X. Have your doctor get on the stick and also write a letter to DH's employer. I doubt the employer wants to be liable for a diabetic coma or shock. Telling you to foot extra money is BS. Push comes to shove, order from Canada. And I can't believe a local pharmacy can't fill a 90 day supply. Greed at the expense of person's health. This is worse the than the $25 I had to pay for 2, yes 2 antibiotic tablets from the ER.
 

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Please complain long and hard to the plan manager at your company if this coverage is from work, and to the ins. company that it is costing you and them more than retail.
 
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