Fighting every month with insurance over $.37 prescription

[cilla4progress]

recently, every month, I am told my $.37 prescription is "out of refills." Costco (pharmacy) tells me to ask doctor. Doctor tells me they took care of it...check with insurance. Insurance says it's doctor.

I'm going on Medicare on 4 months. Is this why?

[Kaleva]

1. If it's just $.37, couldn't doctor just fax script to pharmacy and you pay for it?

[marybourg]

2. If the problem really is the doctor

or the pharmacist, then the same thing could happen on Medicare part D, I assume. You're lucky to have a $.37 Rx

[dflprincess]

3. It might be that the doctor's office has not made it clear

To the pharmacy that it's renewed the prescription for more than the current refill and that's why it's happening everytime. It may be necessary to pick up a new scrpit from the doctor that shows more than one refill is okay.

[Sherman A1]

4. Insurance is a pain in the backside

We are currently trying to convince my wife’s Medicare insurance provider that they are in fact her primary. Sometime last year a lightbulb went off somewhere convincing them that my then Union insurance was her primary and not her Medicare, now we are getting charge backs from two years ago.

We need universal coverage.

[marlakay]

5. I went to get refill last week

Of a medication I have been using for years for sinus stuff a nasal spray. Normally 3-4$. This time they said $18 please.

I said check that no way. So they check and check. Tell me to call my insurance. But I have appointment so call while waiting.

So I go through the whole call press this press that, info about me etc then hold music for 8 min then hangs up! So start all over have a hard time getting through then finally get someone, she says insurance ok call Optum RX so I do go through the whole thing press this that, then they say all should be fine around $4. Put me on hold call my pharmacy, then say you weren’t processed right go back.

So now I go back after appointment and wait in line for second time and ask why wasn’t I processed right, I have been coming here for years. (Small local place) They say don’t know.

All this just for a normal usual simple not life threatening medicine.

[cilla4progress]

6. I know...so effed up.

And underlying it all for me now is that there is no order, only chaos. No justice, only privilege. No rule of law, only of men.

We are going down the tubes folks. Flying down quickly past the rest of other western democracies.

[marlakay]

8. I am retired if I was working

With kids, husband busy life, who has time for all that?

[cilla4progress]

9. Totally...

or if one were actually ill.

Cruel, inhumane system.

[trueblue2007]

14. i have medicare and have Optum RX ... I HATE HATE HATE Optum RX

[Ms. Toad]

7. Prescriptions have changed recently - we battle with them as well.

The current regime is that doctors (generally) want the pharmacy to initiate the process of getting a new prescription once the old has run out. Pharmacies are generally willing to do that - apparently Costco isn't. Complicating matters further is that some doctors ignore requests from pharmacies for a new prescription . . .

It's a vicious cycle since (right now) not everyone is on the same page.

Next time you go to your doctor, get a physical prescription so you are in control of it.

[cilla4progress]

10. Thank you!

I will do that. Or print it out? Seeing Doc on Tuesday.

By the way..I've had a problem with this doctor rationing my health care since I started with her. Intervening between insurance, who was willing to pay, for example, diabetes lancets, telling me they wouldn't pay without even checking 1st (which I did, and they would).

I am starting to wonder (and being paranoid): I feel like this doctor might be a fundie, as many are here. I had an abortion about 30 years ago. I wonder if there is a connection?

[Liberal In Texas]

11. Sometimes you just have to fire the doctor and get a new one.

Staying with doc just because you've been going to them for awhile doesn't make sense when there are so many good ones out there.

Good luck.

[Ms. Toad]

12. Diabetes equipment is odd

It is covered both as DME (durable medical equipment) - for free under my insurance - and - by prescription (at more than $100/month).

I don't know enough about Medicare to sort out who to talk with - but I know that I've been getting diabetic supplies absolutely free through my work insurance, then they switched providers (theoretically same coverage) so I had to figure out a new system. When I shared the info with others with diabetes here, they indicated they have never gotten supplies for free (because they were purchasing them under the drug coverage arm of the plan. Doctors weren't any help in sorting that out, since it really is an insurance issue.

As ot your docotre - who knows. My doctor is a fundie - we always have at least one political discussion when I visit. He cares for our lesbian family competently and without prejudice, and I figure the exposure is good for him. (The only challenge we had was when my daughter needed counseling & he suggested a Christian-based entity. I pointed it out to her so she had a choice.)

[cilla4progress]

13. I have had no political discussions...afraid to.

Have been wanting to bring up my stress due to the drumpf admin. Don't know how it would go over. Don't even feel like i can bring it up! Which is WRONG, am i right?

Unfortunately, we are very limited in doctor choice here - essentially a monopoly.

I'm wavering between continuing to cover it all up (not discuss with her), and just go ahead and disclose and see what happens.