Author Topic: More Insurance Company problems (Read 15419 times)

Long_Haul · « **on:** January 23, 2015, 10:50:32 pm »

This is the fun I had today with my Harvoni shipment for month 2. After seeing the problems that Amy had with her latest script, I got on the phone to Accredo to ensure my status was fine and that there were no issues with my authorizations since my insurance profile changed 1 January. BCBS changed the drug portion of my policy from regular coverage to a Medicare Part D policy. Still with Express Scripts, just a different plan. Well here comes the good part, I checked with two different advocates yesterday and got the same answer. "No, you are fine and your meds have been packaged and are in the shipping department queue". I was relieved. When I got up this morning and checked the online site to get the tracking info and the info was there for the Ribavirin, but not for the Harvoni. I decided to call around noon to see if it actually shipped and was told no.... I went through the roof and told them "You've got to be kidding". After being on hold for about 5-10 minutes, the advocate told me she was embarrassed to tell me the shipment was stopped because there were two prescriptions listed for Harvoni for me. Seems my Doc sent a second script in to cover the 3rd month and when the shipment hit the verification step, the original script was invalidated by the new one. Yikes I hope they figure out how to fix that issue, I bet I'm not the 1st to see this problem.

I got them to schedule me another shipment and it should arrive tomorrow via FEDEX.
Whew, what a scare!

I guess I need to contact my Doc's office to have them make sure that doesn't happen to any other patients.

Please, no more drama... I just want to breeze through to SVR

AL

kate0b1 · « **Reply #1 on:** January 24, 2015, 08:42:57 am »

agh, the ins woes are the worst right? I was weirdly only approved originaly for 8 weeks, not sure why as i am a relapser, I think (and I'm just guessing here) that it was because i only made it to 22 weeks, so not "really" finished. After it was approved my doc appealed it for the 12 weeks and got it overturned (great right?) fast forward to time for the 2nd refill and nope they don't have a rx for the 3rd month (wait what), i made them let me speak to the pharmacist who said she would call the office, next day i get a call from caremark about my ins info, I told the nice girl that they already had that info as its not a "new" rx, oh ok we will roll them together, great !!! I waited 2 days and called back, nope they don't know what I'm talking about, no new rx (can i please speak to someone who knows something), next day I call the office and ask them to please call AGAIN with the rx, the next day i call and go fig there it is, I am a little bit nervous for the call to send it (should be in a week or so), Im trying to hope they got it right this time and I'm so glad i did not wait until it was close to time for me to start it, i think they think I'm kinda crazy lol.

kate

Long_Haul · « **Reply #2 on:** January 24, 2015, 08:49:25 am »

Kate, I am beginning to believe you have to be right on top of this all of the time. Good news is I have the tracking # for the shipment and it is in town, scheduled to be here by noon. I live down a steep hill and we have snow and ICE (5 below last night, headed for 34 above today). Let's see if they can make it down and then back up our private country road. Fingers crossed, have a great day!

AL

kate0b1 · « **Reply #3 on:** January 24, 2015, 09:15:45 am »

of course there is snow at your house lol, i might be waiting at the bottom of that hill for him !

BattleTheBeast · « **Reply #4 on:** January 24, 2015, 02:30:30 pm »

Hi Al,

Hope your meds have made it to you!

Mel

Long_Haul · « **Reply #5 on:** January 24, 2015, 03:47:19 pm »

Thanks Mel, I did get my delivery as promised around 11:15 this morning. The FEDEX guy even had a 4 wheel drive truck so he wouldn't have to get towed out...amazing. I see you are having a good day from your other posts I have read today. Thank you for being so supportive and helping us all through our travels with HCV. I hope you continue to feel better each day, I know I am. I just got back from a vigorous 2 mile walk on some pretty steep hills here in Vermont where I live. Nice and sunny and 38 degrees. A lot better than the -5 last night.

Take care and keep fighting,

AL

BattleTheBeast · « **Reply #6 on:** January 24, 2015, 04:04:23 pm »

Thanks Al,

I feel like we are all here to lift each other up and help through those tough days. I know there are a few people who really carried me through my first few weeks after diagnosis and the beginning of my treatment.

If we can each help one person then we are doing good and we will all be a success story. The key to this whole thing (life in general) to me is to be positive, learn from my mistakes, help others and be a better person every day.

I had the opportunity through a program at my work to hear about this thing called Kiva so I try to go on there and every couple of months find someone to help. My latest was a local lady working to get credentials to be a primary school teacher in a 3rd world country. It honestly made me smile to know that my little loan from Kiva was not only going to change her life but the lives of her students for many years to come. Here's the link http://www.kiva.org/. Locally I also try to do things to help my local shelter for Battered Woman and Children, I was in an abusive relationship when I was very young and thank god I was able to get out and start over but it's something that's important to me to try and help others in that situation.

For me, when I give back - I receive way more than I can ever give....

Mel

amy1662 · « **Reply #7 on:** January 26, 2015, 12:58:23 am »

Hi Al, I just read your post, I am so glad you got everything straightened out in time to get your medication. Seems we all have to stay on top of these insurance company's. Everything went smooth till the first of the year. I hope no one else encounters any problems. Best thing to do is start looking for our next refill at least two weeks before its due encase there is an issue. I still have 3 weeks coming to me some time this week. Burmans specialty pharmacy sent me a week to hold me over because I was so close to running out. I live on the east coast and we are expecting a pretty big snowstorm tomorrow into Tuesday. I will be on the phone first thing in the morning with my pharmacy to see what day it will arrive. So glad we got each other for support. Take care, Amy

kate0b1 · « **Reply #8 on:** January 26, 2015, 05:47:09 am »

@amy, I hope caremark is at work this am (snow or not), i would like them to set up my last shipment now! I am so worried about this last shipment.

stay warm everyone

kate

ma snart · « **Reply #9 on:** January 26, 2015, 11:53:28 am »

Cigna requires we wait till 21 days to order refills, then pharmacy overnight them, but with snowstorm I would be somewhat nervous as the pharmacy is on Long Island, glad we are not due to refill 4th bottle till next Friday.
Snart

Roger · « **Reply #10 on:** January 26, 2015, 05:21:05 pm »

Al,
Great you got your shipment.
Why is your doc mixing Rib with Harvoni?

Long_Haul · « **Reply #11 on:** January 26, 2015, 07:14:49 pm »

@Roger, fourth time around, and I have cirrhosis. He wanted to condense the TX from 24 weeks of Harvoni. You can do that by adding Ribavirin for a 12 week plan.

The shipment is tucked away for loading into the pillbox on Thursday. I may send for my 3rd bottle after I see my GI Doc on the 4th.

AL

Lynn K · « **Reply #12 on:** January 26, 2015, 08:16:18 pm »

Hi Roger

I am taking Harvoni for 24 weeks and we added Riba at week 9. So i will be treating with Harvoni only for 9 weeks and Harvoni and Riba for 15 weeks.

I am genotype 1a, 3 time null responder to interferon based treatments, plus relapsed after treating with Solvaldi Olysio for 12 weeks.

I also have had cirrhosis for over 7 years so my doctor is trying to give me the best chance of a cure based on my treatment history and current health.

Roger · « **Reply #13 on:** January 26, 2015, 08:36:59 pm »

Al,
My insurance company goofed and gave my order to Walgreen's month 1, then Walgreens and a local pharmacy for month 2 and 3. Since I was on pin's & needles just getting through the insurance maze, when the local pharmacy called me a week earlier than they were suppose to - I RUSHED over there and got my bottle! This was especially helpful on bottle #3 - just in case the insurance company was to change it's mind.

I have no idea how that happened, but it wasn't for me to question the efficiency of my beloved insurance company!

I got all 3 bottles, and at this point I feel better than I have in years. Way fewer aches and pains - far less general sick feeling (actually almost 100% non ill feeling). I took the aches and sick feeling, and brain fog as a sign of age mostly. It was a little age, and a lot HCV!

Long_Haul · « **Reply #14 on:** January 27, 2015, 11:48:44 am »

Great news Roger, keep up the good work and I hope to call next week to get bottle 3 on the way here as soon as possible. I too am feeling over al beter than I have for some time.

Best wishes,

AL

Roger · « **Reply #15 on:** January 27, 2015, 12:48:53 pm »

Al, Is that normal that "you" have to call them, to get the
next bottle? Interestingly enough, both Walgreen's and the
local pharmacy called me to tell me the next bottle is ready
to go. I just assumed all these mail order type places did
the same...

Lynn K · « **Reply #16 on:** January 27, 2015, 02:55:37 pm »

For me the web site says my next refill is available but when I call the specialty pharmacy they say I can't order until I have a 10 day supply.

I called yesterday they said how many days do you have left I said about 10 don't have the bottle handy to check. They are sending on what would be 1 day left good thing I was fibbing and really have 14 pills so I will have 4 day supply when bottle 4 arrives.

Long_Haul · « **Reply #17 on:** January 27, 2015, 03:04:05 pm »

@Roger, Actually, they will likely contact me on the 5th or 6th to tell me to schedule the delivery. I just want to push it up a little. I think they told me once that I could only get current month delivered one week before I took the last pill from the previous bottle. I am going to see if I can push it up a bit. For the most part they have been good about our interactions. I understand there will be snags along the way. This will be the last one

, so I won't sweat it as much. It is also a refill for the only remaining script on file for me. I will keep you posted, one never knows with Express Scripts.

@Lynn K, my Express script online account says I can order now, but doesn't state when it can be delivered. Well, I will give it a shot and see what happens.

AL

Lynn K · « **Reply #18 on:** January 27, 2015, 03:11:41 pm »

Hi Al

If I call express scripts they have me call Accredo Speciality Pharmacy on my page as part of the refill notice it has the Accredo logo yours maybe different but I think Accredo handles all speciality meds for ES

Long_Haul · « **Reply #19 on:** January 27, 2015, 04:23:24 pm »

Hi Lynn, Yes, I do actually call Accredo, must be a little "snow fog" in my head today.

AL

Lynn K · « **Reply #20 on:** January 27, 2015, 04:27:58 pm »

They always want me to have a 10 day supply and then want to ship at 1 day left curious if they tell you.

Roger · « **Reply #21 on:** January 27, 2015, 05:29:24 pm »

When I was approved, my doc's office called me to give me the info
explaining that I can order from Accredo or Walgreen's Specialty. I told
her I know nothing about this and she recommended Walgreen's - explaining
to me that Accredo is really hard to deal with and that if was her, she'd
go with Walgreen's.

So I chose Walgreen's Specialty - and those people were friendly, helpful
and lovely to deal with. I do not understand how that little "local pharmacy"
got my order for #2 & #3 refills though (at the same time that Walgreen's
still had my orders). Makes no sense. The guy on the customer service
line at my insurance company didn't understand it either... and when I
received my orders BEFORE the stated 10 period, he got really nuts on the
phone with me! Didn't matter to me, as I had the bottle(s) in hand, but it
was strange never the less...

BattleTheBeast · « **Reply #22 on:** January 28, 2015, 01:44:32 am »

Roger,

Maybe it's a little push from your guardian angel after everything you have been through with Hep C!

I am sure that the insurance Companies especially Express Scripts and Accredo are a mess, I know because i have been dealing with them myself to get my medication. One person says one thing, another person says another thing and on and on. I was happy to have my third bottle in hand 7 days before I needed it.

I always call exactly 14 days before I run out and get them to schedule my next refill to arrive exactly seven days before(they say you can't get it any sooner). I have had some challenges with that as well and if I call in and get someone inexperienced who gives me grief I just say thank you, hang up and call back for a new representative

Keep battling that beast!

Mel

Lynn K · « **Reply #23 on:** January 28, 2015, 06:34:30 am »

Hi Roger

With my express scripts and Accredo coverage they wont allow anything other than their mail order service unless I want to pay 10 thousand a bottle. Basically they go bat poop crazy on you if you try to get local service

Roger · « **Reply #24 on:** January 28, 2015, 12:54:07 pm »

Hi Lynn,
In my case Walgreen's didn't care about not getting the order,
but the insurance guy went a bit crazy trying to figure out how
the +$30K mistake was made. It was strange, as Harvoni is
only allocated to the top Specialty Drug dispensers (I thought),
and this little local guy is not one of them! He also didn't understand
how he received the computerized order to fill my prescription,
but was glad to make the commission. For me it was nice, as I could
go over there and pick it up immediately - and have possession of the
bottle, in case my insurance company had 2nd thoughts!

For #3, the local guy actually received my order at the end of December -
some 15 days early! Go figure...

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Author Topic: More Insurance Company problems (Read 15419 times)