Meds, Mind, Body & Benefits > Insurance, Benefits Programs & HIV

Mail Order Pharmacy will not accept patient savings card

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keven:
I order Epzicom through mail order which is required by my insurance. The mail order pharmacy will not accept my patient savings card which pays the co-pay. The manufacturer of Epzicom will not process the co-payment payment internally. They say I have to go through the pharmacy.

Any suggestions?

mitch777:
I contact your state's insurance commissioner and find out if it is "legal" for a mail order pharmacy not to accept.
Wish we all had better options. ::)

intaglio:
I had this issue happen to me this January. Medco was bought out by Express Scripts. I got a nice letter saying nothing would change. Then I got a nicer letter saying that I had to get all my maintenance meds through the mail-order pharmacy after two refills or pay full price.

The copay programs I participate in have ways to reimburse you. You have to call their customer service line and ask for the process. Mine involved filling out a form and providing documentation that you are required to purchase your drugs through the mail-order pharmacy.

You see, when I went back to Express Scripts and asked where it was in writing I was required to submit my scripts to their mail-order pharmacy, I found out they were blowing smoke. They wanted me to submit my scripts, but they couldn't require me to submit them.

Bottom line -talk to your insurance provider. Request written documentation you are required to submit the scripts to their mail-order pharmacy. If they cannot provide you the written documentation, you should still be allowed to fill your scripts locally -as I am.

If they do require you to submit to the mail-order pharmacy, you're going to need the documentation anyhow. You'll then have to pay for the script out-of-pocket, then submit for reimbursement from your copay program using their forms.

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