PRESCRIPTIONS

COBRA666
COBRA666 Member Posts: 2,401

PRESCRIPTIONS are becoming a real hassle for me. I have plenty of refills, but when I go to get them refilled I hear, The insurance company has not cleared and have to give it a few days. The perfect answer when you don't have a few days because you are out of medications. The only other option is to pay out of pocket. Anybody else having these problems?  The pharmacist told me it seems to be the coming trend. Hope you do not ever have these issues. BTW: I do not have a fly by night insurance co either. I have BC & BS. Never had any problems until the 1st of the year. John

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Comments

  • Shoopy
    Shoopy Member Posts: 210
    Rx

    It sounds like BCBS wants to approve refills...just not the original Rx.  God, I hope that's becoming a trend!

  • COBRA666
    COBRA666 Member Posts: 2,401
    Shoopy said:

    Rx

    It sounds like BCBS wants to approve refills...just not the original Rx.  God, I hope that's becoming a trend!

    You do????

    Karl,

      You just may change your mind if you have to start paying out of pocket while waiting for them to approve the refills. Already had to do that. You can forget reimbursement. I have had BCBS forever and never a problem.There are some medicines you can't wait to have refilled.  John

  • Shoopy
    Shoopy Member Posts: 210
    COBRA666 said:

    You do????

    Karl,

      You just may change your mind if you have to start paying out of pocket while waiting for them to approve the refills. Already had to do that. You can forget reimbursement. I have had BCBS forever and never a problem.There are some medicines you can't wait to have refilled.  John

    Whoops...my bad

    John,

    Sorry...omitted one small word!  It should have said "I hope that's not becoming a trend!"

    Karl

  • COBRA666
    COBRA666 Member Posts: 2,401
    Shoopy said:

    Whoops...my bad

    John,

    Sorry...omitted one small word!  It should have said "I hope that's not becoming a trend!"

    Karl

    thank goodness

    THANK GOODNESS!!!!!.... I was starting to get worried there. LOL...The pharmacist said it is not a good sign of things to come. john

  • allmost60
    allmost60 Member Posts: 3,178
    COBRA666 said:

    thank goodness

    THANK GOODNESS!!!!!.... I was starting to get worried there. LOL...The pharmacist said it is not a good sign of things to come. john

    One...

    Hi John,

     I only have one prescription and one for Steve. Both of ours have a 3 month/ 90 day supply when filled, so we haven't had to do a refill yet. I guess I'll find out when it's time, the last of March. UGH! Nothing worse than running out of medication you take daily. I don't think any of this is going to get any better either. Hey...I'm glad you still have power...hope the worst of the bad weather is behind you now.

    Take care...Sue

  • Rocquie
    Rocquie Member Posts: 859 Member
    Rx

    Hi John, that is nothing new for me. Our insurance company has always been strict about getting refills early. If the script is for 30 days, I can get it 3 days early, but no earlier. If there is a reason I ran out early, or need it early, I just call or ask my pharmacist to call and they always approve it. Have you contacted your insurance company to ask if they have a new policy?  

    Good luck; I'm sorry you are having hassles.

    Cheers,

    Rocquie

     

  • COBRA666
    COBRA666 Member Posts: 2,401
    Rocquie said:

    Rx

    Hi John, that is nothing new for me. Our insurance company has always been strict about getting refills early. If the script is for 30 days, I can get it 3 days early, but no earlier. If there is a reason I ran out early, or need it early, I just call or ask my pharmacist to call and they always approve it. Have you contacted your insurance company to ask if they have a new policy?  

    Good luck; I'm sorry you are having hassles.

    Cheers,

    Rocquie

     

    Becky,

      We have always been allowed to get medications filled a day or 2 ahead of time before. This last time went to pick up 1 and pharmacist said insurance says must get approvel from Dr. Hey,Knock, Knock it says 2 refills on the bottle. Now we wait for the Dr. to call the insurance co. and the insurance co. has to approve the refill. We have had it take as long as 10 days. It has happened with 2-3 meds so far since January 1st. I had a person in front of me the last time and their bill was over $800. They just took out their medical card and swiped it with no co-pay. Tax Payers treat !!!!. I on the other hand had to pay out of pocket and I have insurance. It's only going to get worse. John

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,736 Member
    Insurance

    John,

    A friend's elderly mother (92)  fell on her face two weeks ago, breaking her nose and lying in a pool of blood until he and has wife went over and found her (she lives alone, and is totally clear-headed). After her time in the E.R. and a few days in the hospital, she was then perscribed some time at a Nursing/Rehab facility, which she had been a patient in before.  She has Medicare and a good supplement.  Her card states that "for Nursing visits of less than 8 Days, no Copay is required."    The bean-counter in Admitting demanded $600.00 nonetheless, despite her son telling her, "Last time she was here, you did the same thing, and it took about a month for me to get the front-money refunded, which the policy tells you is not necessay anyway."  The Admitting clerk's point was "we so seldom get paid by carriers that we have to fight for every penny." He explained that that was not their fault, and that she was violating the stated terms of the policy.  Eventually, she got Admitted, after a disguisting and nerve-racking argument in front of a very ill patient.

    Insurance companys being jerks is not new, of course, it just seems that they have ramped up there obnoxiousness a bit.  When I was discharged following my wreck in 1987, in which I spent 25 days in ICU and a few more weeks in acute care, as the nurse was rolling me out to the car to go home, we made a "right turn" into "Billing."  I could not hold my head up by myself, had not worked in two months, and would not work again for over a year, but I did have excellent insurance. The "nice lady" demanded to know exactly what my "monthly payment" would be, and after inventing a number, she demanded to know what date of each month the payment would be made.  She was a real delight, and the whole exchange was totally unnecessary.  She had about the compassion of a Soviet guard at the Siberian gulag.

    The VA Hospital in my state has been under federal investigation for gross mismanagement and causing the deaths of numerous patients being unable to get surgery for colo-rectal cancers.  When I used to go to another VA Hospital decades ago, if my "income changed more than a few hundred dollars, the accounting system would send me elaborate notices of how my drug copays had changed. It would be something like a change to 30 cents per perscription, verses the pervious amount of, say, 25 cents per perscription.  For the administrative and accounting costs of adjusting a nickle, they probably spent thousands opf dollars, to meaninglessly nit-pick, but you have to smile and wait.

    So, none of this is new. About all we can do is deal the insurance cards dealt us.

    max

  • illead
    illead Member Posts: 880 Member

    Insurance

    John,

    A friend's elderly mother (92)  fell on her face two weeks ago, breaking her nose and lying in a pool of blood until he and has wife went over and found her (she lives alone, and is totally clear-headed). After her time in the E.R. and a few days in the hospital, she was then perscribed some time at a Nursing/Rehab facility, which she had been a patient in before.  She has Medicare and a good supplement.  Her card states that "for Nursing visits of less than 8 Days, no Copay is required."    The bean-counter in Admitting demanded $600.00 nonetheless, despite her son telling her, "Last time she was here, you did the same thing, and it took about a month for me to get the front-money refunded, which the policy tells you is not necessay anyway."  The Admitting clerk's point was "we so seldom get paid by carriers that we have to fight for every penny." He explained that that was not their fault, and that she was violating the stated terms of the policy.  Eventually, she got Admitted, after a disguisting and nerve-racking argument in front of a very ill patient.

    Insurance companys being jerks is not new, of course, it just seems that they have ramped up there obnoxiousness a bit.  When I was discharged following my wreck in 1987, in which I spent 25 days in ICU and a few more weeks in acute care, as the nurse was rolling me out to the car to go home, we made a "right turn" into "Billing."  I could not hold my head up by myself, had not worked in two months, and would not work again for over a year, but I did have excellent insurance. The "nice lady" demanded to know exactly what my "monthly payment" would be, and after inventing a number, she demanded to know what date of each month the payment would be made.  She was a real delight, and the whole exchange was totally unnecessary.  She had about the compassion of a Soviet guard at the Siberian gulag.

    The VA Hospital in my state has been under federal investigation for gross mismanagement and causing the deaths of numerous patients being unable to get surgery for colo-rectal cancers.  When I used to go to another VA Hospital decades ago, if my "income changed more than a few hundred dollars, the accounting system would send me elaborate notices of how my drug copays had changed. It would be something like a change to 30 cents per perscription, verses the pervious amount of, say, 25 cents per perscription.  For the administrative and accounting costs of adjusting a nickle, they probably spent thousands opf dollars, to meaninglessly nit-pick, but you have to smile and wait.

    So, none of this is new. About all we can do is deal the insurance cards dealt us.

    max

    Hey John

    Think you meant Roquie, not me.  Anyway, we seem to have the opposite problem.  I'm barely home from the doctor and Sam's Club is calling to tell me my prescription is filled.  When I go to pick it up, they often have automatically filled the refills too.  I have a diurectic to go with my blood pressure med which normally costs around $10.00.  They changed to a new drug house or something and the price shot up to $90.00.  I whined a little and the pharmacist said "We'll just give it to you for $10.00", same thing happened when I had it refilled.  Of course that may all change but so far we haven't had any problems.  I know one thing tho, I won't pay $90.00, the doc will just have to put me back on HTZ

    Becky

  • COBRA666
    COBRA666 Member Posts: 2,401
    illead said:

    Hey John

    Think you meant Roquie, not me.  Anyway, we seem to have the opposite problem.  I'm barely home from the doctor and Sam's Club is calling to tell me my prescription is filled.  When I go to pick it up, they often have automatically filled the refills too.  I have a diurectic to go with my blood pressure med which normally costs around $10.00.  They changed to a new drug house or something and the price shot up to $90.00.  I whined a little and the pharmacist said "We'll just give it to you for $10.00", same thing happened when I had it refilled.  Of course that may all change but so far we haven't had any problems.  I know one thing tho, I won't pay $90.00, the doc will just have to put me back on HTZ

    Becky

    ????????

    THIS IS LIVING PROOF THAT CHEMO BRAIN IS ALIVE AND WELL. JOHN...I THINK!!!!Smile

  • Rocquie
    Rocquie Member Posts: 859 Member

    Insurance

    John,

    A friend's elderly mother (92)  fell on her face two weeks ago, breaking her nose and lying in a pool of blood until he and has wife went over and found her (she lives alone, and is totally clear-headed). After her time in the E.R. and a few days in the hospital, she was then perscribed some time at a Nursing/Rehab facility, which she had been a patient in before.  She has Medicare and a good supplement.  Her card states that "for Nursing visits of less than 8 Days, no Copay is required."    The bean-counter in Admitting demanded $600.00 nonetheless, despite her son telling her, "Last time she was here, you did the same thing, and it took about a month for me to get the front-money refunded, which the policy tells you is not necessay anyway."  The Admitting clerk's point was "we so seldom get paid by carriers that we have to fight for every penny." He explained that that was not their fault, and that she was violating the stated terms of the policy.  Eventually, she got Admitted, after a disguisting and nerve-racking argument in front of a very ill patient.

    Insurance companys being jerks is not new, of course, it just seems that they have ramped up there obnoxiousness a bit.  When I was discharged following my wreck in 1987, in which I spent 25 days in ICU and a few more weeks in acute care, as the nurse was rolling me out to the car to go home, we made a "right turn" into "Billing."  I could not hold my head up by myself, had not worked in two months, and would not work again for over a year, but I did have excellent insurance. The "nice lady" demanded to know exactly what my "monthly payment" would be, and after inventing a number, she demanded to know what date of each month the payment would be made.  She was a real delight, and the whole exchange was totally unnecessary.  She had about the compassion of a Soviet guard at the Siberian gulag.

    The VA Hospital in my state has been under federal investigation for gross mismanagement and causing the deaths of numerous patients being unable to get surgery for colo-rectal cancers.  When I used to go to another VA Hospital decades ago, if my "income changed more than a few hundred dollars, the accounting system would send me elaborate notices of how my drug copays had changed. It would be something like a change to 30 cents per perscription, verses the pervious amount of, say, 25 cents per perscription.  For the administrative and accounting costs of adjusting a nickle, they probably spent thousands opf dollars, to meaninglessly nit-pick, but you have to smile and wait.

    So, none of this is new. About all we can do is deal the insurance cards dealt us.

    max

    Bean Counters

    Max, I spent an unfortunate couple of years, unsuccessfully, in medical billing. What a nightmare! In all my working years, I have never worked with such an incompetent and lackadaisical bunch of people. The gossip, office politics, and back stabbing were also the worst of any job I ever had. The Collections Manager (talk about a "sweetheart") wound up firing me--and I swear I am not making this up--for "being too nice". She actually told me on more than one occasion that I needed to be more of a b*tch. Her exact word. 

    For all the love, care, concern, compassion I have seen and felt among clinical staff--doctors, nurses, techs, therapists, even dietary staff and even cleaning crew, I have never been able to figure out why the caliber of people that gravitate to/are hired to fulfill medical office administrative duties seem so consistently nonchalant and abrasive. 

    Rocquie

     

  • COBRA666
    COBRA666 Member Posts: 2,401
    Rocquie said:

    Bean Counters

    Max, I spent an unfortunate couple of years, unsuccessfully, in medical billing. What a nightmare! In all my working years, I have never worked with such an incompetent and lackadaisical bunch of people. The gossip, office politics, and back stabbing were also the worst of any job I ever had. The Collections Manager (talk about a "sweetheart") wound up firing me--and I swear I am not making this up--for "being too nice". She actually told me on more than one occasion that I needed to be more of a b*tch. Her exact word. 

    For all the love, care, concern, compassion I have seen and felt among clinical staff--doctors, nurses, techs, therapists, even dietary staff and even cleaning crew, I have never been able to figure out why the caliber of people that gravitate to/are hired to fulfill medical office administrative duties seem so consistently nonchalant and abrasive. 

    Rocquie

     

    Hmmmm!!!!

    Rocquie,

      I was wondering where all the "DMV" workers got their training. Thanks for the info, that was #4 on my bucket list. You wouldn't have any idea how they get that peanut inside those M&M's would you?  JohnLaughing

  • Rocquie
    Rocquie Member Posts: 859 Member
    COBRA666 said:

    Hmmmm!!!!

    Rocquie,

      I was wondering where all the "DMV" workers got their training. Thanks for the info, that was #4 on my bucket list. You wouldn't have any idea how they get that peanut inside those M&M's would you?  JohnLaughing

    John

    Don't get me wrong, I am an accountant. I have made a career of counting other people's money. Someone has to count the beans. I just know you can care about people, care enough to do good and accurate work, speak respectfully to people, most especially patients in medical settings. As far as the DMV goes, I can see where some attitude can come about over time. Have you ever had the pleasure of working for the public??  

    Rocquie

     

  • Rocquie
    Rocquie Member Posts: 859 Member
    COBRA666 said:

    Hmmmm!!!!

    Rocquie,

      I was wondering where all the "DMV" workers got their training. Thanks for the info, that was #4 on my bucket list. You wouldn't have any idea how they get that peanut inside those M&M's would you?  JohnLaughing

    John

    Don't get me wrong, I am an accountant. I have made a career of counting other people's money. Someone has to count the beans. I just know you can care about people, care enough to do good and accurate work, speak respectfully to people, most especially patients in medical settings. As far as the DMV goes, I can see where some attitude can come about over time. Have you ever had the pleasure of working for the public??  

    Rocquie

     

  • Drugs

    We had that problem when we were working. CIGNA was really bad in that regard. No such issues now with medicare and Humana. I have to say that CVS would always get us the meds some way, even if they just advanced a few pills. I am trying to get off meds completely. Think I will always need the statin though. I am down to two pills a day, one of which is for arthritis and the other for triglycerides. The arthritis pill I skip on good days or alternate one day drug with one day acetomenophene. My Dr says the acetomenophen has worse side effects than the celebrex.

  • COBRA666
    COBRA666 Member Posts: 2,401
    Rocquie said:

    John

    Don't get me wrong, I am an accountant. I have made a career of counting other people's money. Someone has to count the beans. I just know you can care about people, care enough to do good and accurate work, speak respectfully to people, most especially patients in medical settings. As far as the DMV goes, I can see where some attitude can come about over time. Have you ever had the pleasure of working for the public??  

    Rocquie

     

    Only making a Joke

    Rocquie,

      I was only making a joke to put a little humor in. Yes, I have worked with the public and it was an experience I do not recommend for the weak at heart. It doesn't take long to see how people can be. They have a way of turning you bitter. Eveyone that has worked with the public for any length of time could probably tell some real horror stories.  For some reason though I have found going to the DMV you will find the most monotone talking, uncaring and heartless workers anywhere. Of course that has just been my experience. John

  • COBRA666
    COBRA666 Member Posts: 2,401
    unknown said:

    Drugs

    We had that problem when we were working. CIGNA was really bad in that regard. No such issues now with medicare and Humana. I have to say that CVS would always get us the meds some way, even if they just advanced a few pills. I am trying to get off meds completely. Think I will always need the statin though. I am down to two pills a day, one of which is for arthritis and the other for triglycerides. The arthritis pill I skip on good days or alternate one day drug with one day acetomenophene. My Dr says the acetomenophen has worse side effects than the celebrex.

    hEARD THE SAME THING ABOUT DRUG SIDE EFFECTS

      GKH,

       I have heard ALL medicines have side effects and most are not good. Just look at the commercials on TV about drugs they are trying to push. They tell you all the benefits with words like, could, can, may, but never say WILL and then tell you the possible side effects. There are a few that tell you lymphoma or other cancers can develope as well as strokes from this drug. The simple aspirin has numorous side effects as well as causing stomach ulcers. If you type in any drug I think you will see they all have side effects that at times can scare you. I guess it all comes down to weighing the benefits of what we put into our body.  Even having lawyers advertising class action(make us rich) suits on TV for certain drugs that have been pushed in the past.   John

  • illead
    illead Member Posts: 880 Member
    COBRA666 said:

    hEARD THE SAME THING ABOUT DRUG SIDE EFFECTS

      GKH,

       I have heard ALL medicines have side effects and most are not good. Just look at the commercials on TV about drugs they are trying to push. They tell you all the benefits with words like, could, can, may, but never say WILL and then tell you the possible side effects. There are a few that tell you lymphoma or other cancers can develope as well as strokes from this drug. The simple aspirin has numorous side effects as well as causing stomach ulcers. If you type in any drug I think you will see they all have side effects that at times can scare you. I guess it all comes down to weighing the benefits of what we put into our body.  Even having lawyers advertising class action(make us rich) suits on TV for certain drugs that have been pushed in the past.   John

    Just wanted to add

    I was on statins, my cholesterol was not high but because of Type 2 diabetes the doctor wanted to get it way down.  He put me on 80 mgs.  Well, after awhile I was getting joint and muscle pain.  I could barely get out of a chair or car and would take awhile to get going. I kept blaming it on getting old, it was horrible.  Then I found out that that is a side effect of statins and you need to take coq10.  The bottle of coq10 even says "to take with statins"  Why didn't the doc tell me that?  I quit the statins and started taking the coq18 400 mg.  The pain went away.  The next time I saw him my cholesterol was higher than it ever was and my kidney labs were abnormal.  I told the doc why I quit the statins and he changed to a different statin and lowered the dose to 20 mg.  Time went on and then the pain again.  Stupid me, it didn't dawn on me at first.  Then I got a big bulge on my achilles tendon.  I had achilles tendonitis years ago so it flares up at times but never like that.  It was hard as a rock and almost the size of a ping pong ball.  I could barely walk.  I was telling one of the onc nurses when Bill was in for Rit and she said she thought that statins affected the achilles tendon.  I looked it up and sure enough.  We have a great pharmacist and I told her about it and that I was not going to take statins ever again.  She said that she didn't blame me, especially with the side effects I was having.  So now I guess I will have to tangle with the doctor, but I now go to his nurse practitioner and she is 100 times the doctor that he is.  Just beware of those side effects GKH, it doesn't affect everyone that way tho.  Becky

  • Rocquie
    Rocquie Member Posts: 859 Member
    illead said:

    Just wanted to add

    I was on statins, my cholesterol was not high but because of Type 2 diabetes the doctor wanted to get it way down.  He put me on 80 mgs.  Well, after awhile I was getting joint and muscle pain.  I could barely get out of a chair or car and would take awhile to get going. I kept blaming it on getting old, it was horrible.  Then I found out that that is a side effect of statins and you need to take coq10.  The bottle of coq10 even says "to take with statins"  Why didn't the doc tell me that?  I quit the statins and started taking the coq18 400 mg.  The pain went away.  The next time I saw him my cholesterol was higher than it ever was and my kidney labs were abnormal.  I told the doc why I quit the statins and he changed to a different statin and lowered the dose to 20 mg.  Time went on and then the pain again.  Stupid me, it didn't dawn on me at first.  Then I got a big bulge on my achilles tendon.  I had achilles tendonitis years ago so it flares up at times but never like that.  It was hard as a rock and almost the size of a ping pong ball.  I could barely walk.  I was telling one of the onc nurses when Bill was in for Rit and she said she thought that statins affected the achilles tendon.  I looked it up and sure enough.  We have a great pharmacist and I told her about it and that I was not going to take statins ever again.  She said that she didn't blame me, especially with the side effects I was having.  So now I guess I will have to tangle with the doctor, but I now go to his nurse practitioner and she is 100 times the doctor that he is.  Just beware of those side effects GKH, it doesn't affect everyone that way tho.  Becky

    Becky

    You mentioned Coq10. Did you stop taking it? Or do you still take it? Did it have any effect on cholesterol or the statins? Where does it come into play?

    Just wondering,

    Rocquie

     

     

  • Rocquie said:

    Becky

    You mentioned Coq10. Did you stop taking it? Or do you still take it? Did it have any effect on cholesterol or the statins? Where does it come into play?

    Just wondering,

    Rocquie

     

     

    Co-Q10

    They say that statins reduce the body's ability to naturally proce Co-Q10 so people on statins need supplents. I have taken it for years and MD Anderson recommended I coninue. Its not a drug, just a food supplement and is supposed to benefit the cardiovascular system.