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PostPosted: Fri Sep 06, 2013 8:47 pm 
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Hi, I'm really new the forum and hope you don't mind me just barging in on this thread. But, I feel like this might just be the right place for my story. I have been unable to vent about it (except to husband) and feel it would do me (and maybe someone else) some good to get it out. Maybe this should be in a pharmacy thread?

I've been (very contentedly) on Suboxone for almost 2.5 years. The first six months or so were covered by my insurance BCBS. Then, I got a lovely letter saying they thought I should be just fine and dandy in another month at which point they would discontinue coverage. Well, thankfully, my husband is a lot more supportive than I had worried and has been putting money aside for me to pay out 400-500 each month for my script. I rationalized that my pill habit cost quite a bundle too and so I deserved to be punished by paying out of pocket this enormous amount each month.

Anyway, my dose has been steadily going down as I've been happily on a very very slow taper. However,my last visit to the pharmacy was so traumatic, that it has motivated me to get done earlier rather than later. (*which is sad because that should NOT be my guiding force).

To make a long story short, I have reduced from the 8 film to the 2s. Since these films are prescribed for 3 times a day, that means a month worth is 90 films. I submitted the prescription and reminded them insurance doesn't pay and I'll be paying cash (or health savings deposit to be exact). After an hour of waiting, I asked if I could help and they said that they were just waiting to see if insurance would go through. ugh. So, I said, no it won't go through because I'm paying cash. They also didn't remember that I was a "waiting" customer. I usually wait because they ALWAYS have some kind of hangup about the insurance thing. Well after every pharmacist and pharmacy tech eyeballed the prescription and me and proceeding to holler loudly to each other "Hey! Do we have NINETY of these things. She wants NINETY!!" All while waiving films around for each and every customer in the shop to see. And after being asked 500 hundred times if I'm SURE I want ALL ninety right now, they finally admit that they do not have 90 in inventory and that they could give me a partial. I thought this would be like 45. I heard the pharmacist tell the tech that "it would be in her best interest if she just take home a 4 day supply". I got the feeling that if I complained about this, they would assume I was "abusing" the med. In fact, I got the feeling they could pull the plug on the whole thing if they so desired for any reason. So, I was given a 4 day supply, told to come back on Monday. In total, this was an hour and a half ordeal. And by the end of it, I was crying in my car. Middle age mother of two crying in the car because of the shame and frustration of the whole thing. Someone suspicious of me would think I was upset because my scam of trying to get my full prescription was busted.

All weekend I worried. Worried that they would forget to order more. Worried that they wouldn't honor the remaining. Worried that I'd have to go to the ER if I couldn't get them in time. This is all triggering addict thinking and it immediately reminded me of the many reasons I hopped off that opiod rollercoaster in the first place. Monday comes and I call first so as to insure there will be no problem when I come back to the pharmacy. This is when they tell me that the process is being hung up in insurance. And here we are full circle. My insurance hasn't paid in over 2 years. I reminded them that I pay cash and they again said, are you SURE you want to pay all that today. Seriously. Does anyone else get asked if they want an ENTIRE MONTH of their zoloft all at once? It was then that I had to painfully admit that I had been so humiliated by this transaction that yes, indeed, I want ALL 90 of those suckers RIGHT NOW.

After this experience, I began searching for other stories like this. It is so disheartening to read just HOW many other stories there are. It made me realize how lucky I was to not have had many problems over the past 2 years. But, it shouldn't be up to LUCK. We shouldn't have to feel like we're at their mercy. Or made to feel like a junkie and trying to pull a fast one. We are the ones RECOVERING. Why start hassling us NOW?

Thank you so much for reading this. Turns out my short version of the long story wasn't so short, so I appreciate anyone getting through it. Just writing it all out and telling someone has made me feel so much better. I look forward to becoming more active in this forum. It looks to be a very supportive and non judgmental place.

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PostPosted: Fri Sep 06, 2013 9:20 pm 
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Hello Minnie and welcome to the forum. Wow, I would have been so upset I may have said something I would definitely had been sorry for later at that pharmacy! How dare the pharmicist wave your med around for everyone to see and holler to each other like that. What is wrong with people?

I bet if you would have INSISTED they give you the full script of subs you would go somewhere else they may have changed their tune? Maybe not as they seem to be not so customer-friendly after all. It is a huge money-maker for them and you insisting they give you all the subs coming or you would go somewhere else may have produced different results. Again, maybe not.

First I would positively find another pharmacy. Even if you have to drive MUCH further it would be worth it to receive the kind of service you and all of us deserve. I might explain to the new pharmicise exactly why you are changing and hopefully that will never happen again to you.

I might also have a serious talk with your sub doctor and explain to them that you are not ready to get off the subs. Tell the doctor your insurance stopped paying because they thought it was time you got off and see if the doctor could give you a letter stating the fact that you simply need to be on it a while longer due to perhaps relapse possibilities. That may just help. Maybe the doctor, if he or she is truly a caring and concerned doctor, might call your insurance for you?

I would certainly try everything in my power to first get the insurance to pay for the meds, and absolutely, positively find a different pharmacy. Asking the doctor about the insurance issue may not help, but at least you tried. But even if you are required to pay out of pocket I would be at the new pharmacy the very next time, and file a report towards the previous pharmacy with the pharmacy board that handles such things. The way you were treated is absurb in my opinion Minnie!

My thoughts on the matter anyway, and others here may have different opinions and suggestions for you.

I wish you the very best of luck and hope you get this issue fixed. Again welcome to the forum and please continue to post and inform us of any outcome. Take care and have a nice weekend!

Karen xoxo


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PostPosted: Fri Sep 06, 2013 9:21 pm 
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I can so relate.. I had more than my share of pharmacy screw ups, and of course, because of the type of medication, we're always the shady person in the wrong. What they don't know is that a lot of us "shady addict" folk could do their jobs with our eyes closed and our hands tied behind our backs.

There was a point where I would often only get a partial fill, usually due to stock, etc. The pharmacy was right next to my apartment building so it was really easy to pop in anytime and get the remaining fill, so I never really worried about it. One time, I went in early to get the rest of the month's fill because I was leaving the next day for a trip to CA for 2 weeks. I get there and they proceed to tell me that I cannot get the remaining amount because the system still shows I have enough for a few days. I tried to explain that I was leaving tomorrow and my few days of doses would not get me very far in CA, but it was like talking to wall. I think they just assumed I was lying. wtf?

Then I tried to use logic. I explained to her that refilling the rest of my month's script now, is NO DIFFERENT than me getting all my script filled at once at the start of the month. And that I shouldn't be punished because they couldn't fill it all at once. I went so far as to pull up my flight confirmation and show the stupid bish that I was leaving in the AM and I would freak the eff out if she didn't refill me. She did. :wink:

Anyway, it's times like that where my gut would fall through the floor and I felt really unstable. I traveled a lot though, for work, and so it became a regular thing to worry about not having meds for out of town trips. It's a scary thing.

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PostPosted: Fri Sep 06, 2013 9:38 pm 
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tinydancer wrote:
I can so relate.. I had more than my share of pharmacy screw ups, and of course, because of the type of medication, we're always the shady person in the wrong. What they don't know is that a lot of us "shady addict" folk could do their jobs with our eyes closed and our hands tied behind our backs.



Isn't that the truth! I've always said, and always will say that addicts are some of the most kind, caring, compassionate and INTELLIGENT people there is. Very often we're treated like pond scum and it's sickening at times. Well said Tiny!
Karen


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PostPosted: Fri Sep 06, 2013 10:18 pm 
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Wow! I wasn't expecting replies so fast or even as many replies. Makes me feel better already.

Brown Eyed Girl, I will definitely say something to the doctor about the $ I actually wasn't aware of any other option until this forum. I am not an assertive person by nature. I really do need to be a little more proactive. It's not like the doctor will throw me out of his program for asking a question. I've always been afraid to ask questions. Thank you for reminding me to be a better advocate for myself.

Tiny dancer: YES! Your story about trying to get access to more (of YOUR) films is exactly the frustration I had. It's not like you were asking for extra. If you had gotten your entire month's already they wouldn't be telling you how many strips to pack. One of my fears over that weekend was that I would get there Monday and they would give me another 4 day supply. Technically, this is fine. I take them as prescribed, but what was to keep them from asking me to come in every 4 days or 2 days or 1 day! How long could this go on! I truly panicked that weekend. It makes me want to stockpile and hoard all my medication in a tree.

Thank you again. I'm happy to be a part of this.

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PostPosted: Sat Sep 07, 2013 12:27 am 
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I want to first say hello and welcome glad your here just as happy as I am able to be here. I am sure we have all had our share is pharmacy eff ups mine are ten dollars a film almost and at 12mgs a day that's is 450 dollars so yes I know the struggle sometimes if I fill my script before my insurance allows me to then I get to pay for them out of pocket which is painful and the looks you get fro people who see you take it or the people who work there look at us like junkie especially in little town pharmacies the people there are disgusted by my husband and I and I hate it sometimes because they watch you walk around and carefully scrutinize you thinking you are just a junkie and you are liable to steal shit. Then it takes a real long time to get them to fill your script. Assbags sometimes they think they control everything cause they hold out script fuck them


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PostPosted: Sat Sep 07, 2013 2:14 am 
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My LATEST pharmacy problem:

My sub doctor prescribes me a relatively new medication called Nucynta for my migraines and any other kind of breakthrough pain I have. It is a synthetic opiate I believe. My doctor prescribes it for his sub patients if they need it because it doesn't cause the euphoria most opiates cause. Plus I he prescribes the extended release version so I really could never feel euphoria from it.

My King Soopers (grocery store) pharmacy couldn't fill the entire script for 30 Nucynta 100 mg ER, but the tech told me I could fill the rest of it when they get it in. Wrong! When I came back the pharmacist said that none of her staff would have told me that because Nucynta is a schedule 2 drug and it requires a new prescription for every fill. They told me I'd have to get another script from my doctor.

It was really no big deal because I didn't need more than the 20 anyway and I got another prescription from my doc the next month. Apparently, Nucynta is not well stocked at pharmacies because it's fairly new and not so popular. I had to call other King Sooper pharmacies to locate the Nucynta. I found one and went there to have it filled. When I opened the bottle I noticed that the pills were a different color. But what did I know? Maybe it was generic.

Two days later I got a call from the pharmacy on my cell. They had given me the immediate release Nucynta instead of the extended release. The pharmacist apologized profusely and said that she would find me the 30 Nucynta ER (they didn't have that kind in stock), refund my money and give me the Nucynta ER for free.

Great deal, right? Well, it would have been fine, but somehow between the apologetic phone call and the time I picked up the right meds she decided she was angry. So when I picked the meds I got a tirade about how I needed to pick up all my prescriptions from the same pharmacy and that I should have had my regular pharmacy order the medication if they were out of it. I said, "That's why I came to another King Soopers Pharmacy and don't you have a shared database?" "Well, yes, but you should have had your home pharmacy order this in for you if you knew you'd be getting this prescription!" Whatever!

By the way, welcome to the forum, Minnie! We hope you stick around and let us know more about you!

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PostPosted: Sat Sep 07, 2013 9:10 am 
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I gotta a question:
Exactly who the HELL do some of these pharmacy techs/pharmacists think they are? I mean, are they pissed because they aren't the doctor giving the order to fill said medications? If so, they should go back to school and take some more classes, otherwise, they are paid to do a job...if they are unhappy or feel as though they need to change the world with their pharmaceutical powers, then they should check their ego at the door and do what they get paid to do.

My pharmacist? I went to school with her. The partner in the pharmacy with my school friend? Her husband is a Plant Control Operator at the power plant with my wife. We all know each other, and are friends first..then business second.
Where else could you have a "tab" on your pharmacy bill? Especially for something like Suboxone?? I do just that every month...normally the day I get my Sub is like, two days before payday (on a two-week payscale)...so I just tell Rachel, my friend, that i need to come back thursday and pay her...and she never has a problem with that. And I never forget or leave her owing money...the old mom and pop pharmacies used to be this way, but then they mostly got ruined by us addicts in active addiction, so they quit doing that and it's hard to find one that will let you do it.

back when I was on the Sub pill, I had been in to Fred's so often that I became friends with the pharmacist in there, named Jim. Jim knew that WAY BACK THEN, my wife and I both were unemployed, and my wife was in college...and he would help me anyway he could. I never had insurance back then, so Jim would fill 2, or 3, or 5 pills...then I would come back a few days later and get more...He even would let me slide from Monday until Wednesday when unemployment pay went into the card, and would give me 3-5 to do me until then, but if he ever got caught, he would've been in trouble, so I didn't ask him to do it often unless it was emergency...

I guess I'm just lucky I haven't encountered what some of you guys have..I would likely end up in jail!!!

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PostPosted: Sat Sep 07, 2013 12:09 pm 
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It's comforting in a strange way to know that it's not just me that this happens to. I mean, it's a tragedy in its own way that it happens to so many yet comforting I'm not alone? Does that even make sense?

This last episode made me realize how fortunate I was to only have to deal with sideway looks when I pick up my med. Although, we don't deserve the sideways looks either. I'm basically so ashamed at the pharmacy that I don't even take my little girls with me anymore. I don't want them to see their mother being looked at as a piece of shit by these nice professionals that they are taught to trust. My father is a physician and it sure would freak them out to see the conflict of attitude.

I always thought *I* should be treated differently because I never doctor shopped or lied while in active addiction. I never swindled nothing lol! THEN it finally occurred to me that although I never personally had to, I still was supporting diversion by getting them "off the street". So, back to piece of shit I am lol. Lately, I've come to realize that even though I may be a piece of shit, I'm still a mother trying to stay healthy. I'm a daughter, a mother, and looks to me that the nation is filled with good people just like me trying to get well Pharmacies and doctors need to get up to speed on this judgment situation - lest they be judged themselves.

One pharmacist actually told me that this medicine is supposed to be prescribed for only 6 months, and then she said, "But. . . whatever". And it was NOT a nice "whatever" whatsoever :oops:

WE are the on the frontline of this. We need to hold our heads high so as to pave the way for others. There's my little inspiration for the day ;)

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PostPosted: Sun Sep 08, 2013 2:03 pm 
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Why do I bother to even answer when everyone said exactly what I would have said to you? Aren't they a great bunch of addicts?!!

All I wanted to add was to back up what Jon said. This has happened before and if I remember the post correctly, the patient told the Sub Dr. what happened and he called the pharmacy and chewed their butts out. It is not their place to question what happens between a patient and their doctor. I would even threaten to inform the authorities who govern the HIPPA laws in your state. They broke your anonymity when talking out loud about you.

In any case, either you, or have your husband go in with you and talk to your doctor. Tell him what you told us here, withholding nothing. My bet is he'll quickly fix this problem with a phone call to your RX.

Welcome to our online support group!

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PostPosted: Sun Sep 08, 2013 3:21 pm 
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And if that fails...call corporate for the pharmacy you used. That always gets their blood boiling when you go above their heads and they get calls from corporate HQ on a customer complaint. Enough complaints roll into corporate, and you'll see changes take place..but it would probably take a complaint or two each day for a week...I'm not sure how many...but let your story be heard. There's a graduating class of new pharmacy tech's and pharmacists every semester, I'm sure...so the field isn't empty and there's always someone willing to do it if the one doing it now doesn't feel up to it. They might think it isn't their job to be customer friendly, but when they find themselves living on pennies, they might have a change of heart and actually give more than two shits about their livelihood.

Talk with your wallet, that always helps too. Tell everyone you know, so they will tell people. The best advertising is word of mouth, and bad news travels faster than good news, ANY DAY. Put it on your facebook, if you aren't secretive with your treatment medicine..if you are, then put something that leaves out the gruesome details, and just say how bad you were treated. You can even say you were picking up for someone else, and change some names...I'd be sure it's well advertised tho.

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PostPosted: Sun Sep 08, 2013 7:23 pm 
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Thanks guys. You really ARE a great bunch of addicts. So many thought provoking and well written posts. Why am I surprised at how thoughtful, sensitive and intelligent us addicts are? It's not how they do us in the movies!

I did call my Dr's office during the whole fiasco. I wanted to keep them aware of the situation but the secretary offered to "straiten' them out" (southern for I got this). I told her she was my last card to play if they kept jerking me around. She was so helpful and recommended some different pharmacies that were better equipped. She disclosed that my current pharmacy had started treating all the clinic's patients poorly lately. I really hope this is not going to be a trend throughout. I won't name the store but it rhymes with Mall Jeans

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PostPosted: Mon Sep 09, 2013 6:42 am 
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As an entirety, it seems they are pretty popular at losing customers in the Suboxone area...surely isn't the first time I've heard someone with bad things to say about their experience at Walgreens...and won't be the last either. There's one here, where I live, but I avoid them like the plague, and I think the only time I've ever been in was when my daughter came out of a doctor appointment and needed something, the pharmacy was right across from the hospital and we had it sent there for ease of access...but we quickly changed once we got settled...
I've never filled any of my own personal meds in there, and won't...

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PostPosted: Mon Sep 09, 2013 10:19 am 
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jonathanm1978 wrote:
As an entirety, it seems they are pretty popular at losing customers in the Suboxone area...surely isn't the first time I've heard someone with bad things to say about their experience at Walgreens...and won't be the last either. There's one here, where I live, but I avoid them like the plague, and I think the only time I've ever been in was when my daughter came out of a doctor appointment and needed something, the pharmacy was right across from the hospital and we had it sent there for ease of access...but we quickly changed once we got settled...
I've never filled any of my own personal meds in there, and won't...


I've always had good luck with the one my doctor initially recommended. They always had the 8mg and never gave me much 'tude. But, they didn't have 2mg in stock and suggested the other branch - Which I will NEVER go to again. I sat and watched the sheer amount of business they have and it made me a little sick to my stomach. Everyone is on drugs! The whole world! Granted, they might not all be narcotics. . . but there was a constant, steady and sometimes congested traffic at that pharmacy. I know they won't miss my measly $500 a month, but I'm boycotting them nonetheless. It's sad, but I use a different friendlier pharmacy for my antidepressant and kids medicine. I didn't want the nice pharmacist to know I was taking sub. Turns out, they all have access to our records anyway. So, sigh. So much for putting up a front I guess. Might as well just get them from my friendly pharmacist and risk the relationship. I'll just use Walgreens for emergency in the middle of the night ear infection antibiotic stuff.

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PostPosted: Mon Sep 16, 2013 11:12 am 
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Hi Minnie

How are you today? My pharmacy story is a bit different & I think sad because it seems like the entire area is on drugs of some sort.

There is a pharmacy that opened about 3 years ago, it's across the street from where i work (a medical building). He has become the "go to pharmacy" for strong opiates & suboxone. He is driving a BMW now with personalized plates...when he opened he had an older honda civic...He has hooked up with all the sub doctors in at least a 15 miles radius. He always has suboxone & when i was using the 80 mg oxycontin it was never a problem getting it filled.

This is where i get my sub filled now & i hate that i am helping pay his mortgage or car pmt. He has a cocky attitude & talks about people behind their backs. He has gone as far as having some arrangement with a "pain mgmt doctor" that i used for a short while. The pharmacist is AT the doctors office on "clinic day" where he fills sub scripts at the doctors office. I don't even know if this is legal. It scares me that we have become a "pill" society. Anyway just wanted to share my pharmacy story.


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PostPosted: Mon Sep 16, 2013 3:32 pm 
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TO OP:

My first thought is that it's becoming rarer and rarer for bigger insurance companies to NOT cover suboxone or at least SOME form of buprenorphine. It's MUCH MORE common, especially was two years ago when this happened to you, for insurance companies to require 6 month authorizations EVERY 6 months from the prescribing Suboxone Dr. I would hate to think this was just some kind of miscommunication/oversight and you could have saved yourself a lot of headache but it's SOMETHING I WOULD LOOK INTO. Talk to your prescribing Doc about 6 month/prior authorizations if this hasn't already been talked about or exhausted. It would really surprise me if there was not some way your Dr could contact BCBS and have some form of buprenorphine covered for you at a co-pay level.

Second thought on the pharmacy situation is that you should have a frank talk with your current pharmacy chain manager, reminding him/her of privacy laws as related to the picking up of prescription medications. If not, you should switch and try to establish a relationship with another pharmacist off the bat by asking to talk to them before you fill your first prescription, before you hand it over to them, explain the scenario regarding what happened at the other pharmacy, let them know you find that sort of conduct unprofessional and unacceptable that you're in recovery and take this medication regularly as you would any other medication and have them assure you that it will not go down that way if you should begin using them as your primary pharmacy. If you're in a small town it may be easier said than done, I know. I live in a TwinCity of a million but I used to have problems at a Walgreens just down the street from me and simply switched to CVS a little farther away but did what I'm suggesting you do at the first visit and now have a GREAT relationship with CVS years later, no problems and they have (sadly enough) surprised me by how much of a human they have treated me.

On the Nucynta note: It would be an interesting new thread to start, it's a CII drug similar in a lot of ways to Tramadol from what I understand...I've seen a couple people on it concurrently with buprenorphine albeit much less than tramadol, I would suspect due to the difference in schedules. I'm guessing the main action when used concurrently would be from the SNRI-like effects as opposed to the opioid effects? But that's my educated guess, I haven't been to medical school.

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PostPosted: Mon Sep 16, 2013 5:41 pm 
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Med school or not---- I think the answers from TwinCities are 'spot on'.


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PostPosted: Mon Sep 16, 2013 9:32 pm 
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Yes, what a great post TwinCities and thank you! I'm going to explore this 6 month authorization thingy. I tend to totally fold under authority and I was too timid to pursue any remedy after I received that letter. It's as if I thought I was being punished and deserved it. Man- that seems to be my lifelong lesson and I have no idea why.
Thank you again. Information is power And it sure cant hurt to ask.

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PostPosted: Mon Sep 16, 2013 9:34 pm 
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Also, I may take notes from your post so I can keep my focus. I am a fairly educated person, but I have a WHOLE lot of ditzy blonde thing going ;)

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PostPosted: Tue Sep 17, 2013 9:43 am 
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Location: West Tennessee
I find it interesting how many different coverage plans there are under the same insurance carrier. I also have BCBS of TN and I have never had a problem with them covering my suboxone. My first doctor filed a PA for me before I ever came in for induction, and they had it ready for me at the pharmacy when I went in for my first scrip. With the copay discount card available from RB I was getting my 30 8mg strips per month absolutely free! It was awesome, and I am forever thankful for it because I know not everybody has the same experience. I honestly don't think I would have been able to stay in treatment if I had to come up with it out of pocket.

I read this thread when the OP first posted it, but didn't have much to add at that point. Since then I have experienced something new with BCBS and I wonder if it might be helpful. I have a close family member who recently started sub treatment. They were paying out of pocket for 60 8mg strips per month. There were several times that they would have strips left on the prescription at the end of the month because they couldn't afford to pick up all of them. The nurse at the sub doctors office noticed that my family member had BCBS coverage and was very surprized they weren't covering any medication. She filed a PA for them and my family member was extremely happy that it was approved and that they would no longer have to pay out of pocket for the entire prescription.

Here's the catch....they went to pick up the next script and the insurance denied the payment! Even with a PA, when the pharmacist called she was told that the insured had to pay 100% of all medications on the plan she had. That was obviously a lie, as this person had been getting prescriptions for other medications paid for with no problems. After considerable effort contacting the insurance company here's what we found out. Yes, the PA was in place. However...they were expected to pay for the prescription every month and be reimbursed for the cost.

Grrrrr...this makes me so angry. I'm sure the company is counting on the fact that some patients won't be able to come up with the money up front and therefore won't bother filing for reimbursement. How many people would have followed up with the company after being denied in the pharmacy? I would say there is a percentage of people who would have been shamed out of following up with it. To me, this practice is just a way to throw another road block up, a way to try and deter patients from getting their life saving medication!

I was completely shocked that the same company which had treated me so wonderfully, was making it so difficult for my family member! I later discovered that there were many different plans within BCBS an employer can choose from. Of course, I'm sure the one this employer chose was a bit less expensive for them.

Anyway, there's my gripe session for the day! :roll:

Q

_________________
No one can make you feel inferior without your consent. ~ Eleanor Roosevelt


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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