POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: keven on May 28, 2013, 09:25:37 am
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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?
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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. ::)
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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.