A Pharmacy Love Story [Not!]

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leggo_my_legs
Posts: 349
Joined: Sun Oct 16, 2016 12:29 am

A Pharmacy Love Story [Not!]

Post by leggo_my_legs »

I went to Target/CVS to fill my 90 day supply of 5 mg Norco. My insurance economically coerces me to fill my rxs at CVS, which I have always hated and wouldn't go there otherwise. I have been really busy lately and it took me 2 days after the MD appt to get to the pharmacy, even though I was out of meds. I only had a little time so I was trying to both drop off and wait for the rx to be ready.

Well, the pharmacy said my insurance denied the quantity because my insurance will only allow a 22 day supply, unless you have a "preauthorization" showing that you need more. And of course for the preauth the insurance company has to talk to your MD. My sleep MD is only in the office a few days a week, and this wasn't one of them.

So then I said ok just fill 22 days worth and I will come back for the rest. Nope. They can't do that; I was told I'd have to "forfeit" the rest of the pills [The pharamacist gets to eat them or what?! :roll: ]. In other words, that would mean I'd have to go back and see my MD again to get another rx before I ran out because where I live you can't have refills on Norco...every new rx you have to go in. I haven't reached my ridiculous $1,750 annual deductible yet, so that means I'd have to pay close to $100 out of pocket to see my doctor again to get another rx. No thanks.

So then I said OK I'll just pay out of pocket how much is it? $86. So I was like screw that, I will take my rx back and go to Costco, where I bet it will be a lot cheaper.

I get to Costco and they refuse to fill the rx because "You haven't filled this medication here in a year, and we have to talk to your doctor to verify the medication. Why haven't you filled it here?" I told them that I was coerced into going to CVS by my insurance company. But they still didn't care, it was a "costco policy."

By that time I started actually sobbing in public I was so enraged and frustrated. I felt like every creative solution I tried to come up with was thrwarted by the bureaucracy and I couldn't take it. I asked to talk to the district supervisor to see if costco would make an exception but of course they would not. So then I said well can I call my PCP and have her verify the rx, she knows I'm on it and she knows what it's for.

So I call my PCP's office and the receptionist says, "Well I don't know if she can do that because she didn't write the prescription, but let me check." My PCP is quite reasonable and agreed to verify with Costco that she knows I'm taking the medication. So I was finally able to get it. The whole rigamarole took about an hour and a half.

Costco fills the rx for me and it's $26, compared to Target $86! At the end, the pharmacist says to me, "I'm just going to be straight with you, I'm going to follow up with your other doctor on Monday about this prescription." :roll: I said, "I don't care, she prescribed it for me!"

While I was crying at the pharmacy some nice lady passed by and asked me if I needed a hug. Sometimes strangers can be so nice. I didn't take her up on the hug, but I did tell her why I was so upset and how angry I am that this is how it is in the USA, the insurance companies want to deny care for any reason. It wasn't just the arbitrary 22 day supply, it's everything...my blasted $1,750 deductible, etc (my employer only offers one health plan and this is it).

I emailed my sleep MD about the whole thing and she said she was sorry, that the ins cos have gotten so bad, and everything is now hassled, denied, and questioned to the point that many MDs are going to start not taking insurance anymore.

ViewsAskew
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Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: A Pharmacy Love Story [Not!]

Post by ViewsAskew »

I am SO sorry you had to go through this. It really had gotten so out of hand. Please accept my virtual hug.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Yankiwi
Posts: 548
Joined: Wed Sep 10, 2014 7:20 am
Location: West Coast, South Island, New Zealand

Re: A Pharmacy Love Story [Not!]

Post by Yankiwi »

That's a really horrible (but not all that atypical) story. I'm glad you finally got it sorted out. Here is a website for comparing prescription prices: www.goodrx.com
It's no good in New Zealand but has helped my sister in the US.
Here's a long distance virtual hug for you!

Polar Bear
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Location: United Kingdom

Re: A Pharmacy Love Story [Not!]

Post by Polar Bear »

leggo - I'm so sorry you went through this, I also would have been crying with frustration..
Betty
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

badnights
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Joined: Tue Mar 10, 2009 4:20 pm
Location: Northwest Territories, Canada

Re: A Pharmacy Love Story [Not!]

Post by badnights »

I hate that sort of thing - and the more you show how frustrated and upset you are, the more they think you're a whacko .... you poor thing ... how nice it was that the lady offered you a hug, that must have been the only bright spot in a dark, dark day
Beth - Wishing you a restful sleep tonight
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I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

Rustsmith
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Location: Colorado Springs, Colorado

Re: A Pharmacy Love Story [Not!]

Post by Rustsmith »

I wish that I could say that I have never heard anything like your story, but unfortunately I (and many others) have had much the same experiences. I had one pharmacist tell me that if he filled my prescription that it would get him into trouble. When I went to another pharmacy, they told me that the last guy had logged in my request, which made me look like I was shopping a bogus prescription around. So, they obviously decided not to fill it either because the first guy didn't say why he refused. I asked them how I was supposed to get the medicine that my doctor had legally prescribed and that I very much needed. The second guy simply said "I don't know". I ended up having to use a mail order pharmacy with a 2 week delay and will not gone back to either store ever again.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

leggo_my_legs
Posts: 349
Joined: Sun Oct 16, 2016 12:29 am

Re: A Pharmacy Love Story [Not!]

Post by leggo_my_legs »

Thanks. Yeah it was a miserable experience. I know many here have had similar. I am the type that cries easily and laughs easily. I've cried in public more times than I'd care to admit. Usually people here just ignore you, appear uncomfortable, and pretend you aren't crying. It really was nice of the lady to stop. I was wondering if they were going to sic costco security on me. I'm glad they didn't.

Steve, yeah, it's funny how the more they survey a person the more anxiety-prone behaviors the person displays, which in turn makes them look more guilty. BTW, did you hear a federal bill legalizing marijuana was just introduced? [I'm not optimistic on it passing but thought it would interest you since I recall it's been helpful to you and many others here. I will be watching that bill!]

I had to physically go in to the pharmacy today to buy sudafed...I tried to go through the drive through because I am sick and didn't want to get out of the car. But no, they had to scan my driver's license to make sure I'm not going to make meth with 24 sudafed.

We can't get controlled meds via mail order pharmacies in CA, I don't think. Which is a bummer.

leggo_my_legs
Posts: 349
Joined: Sun Oct 16, 2016 12:29 am

Re: A Pharmacy Love Story [Not!]

Post by leggo_my_legs »

badnights wrote:I hate that sort of thing - and the more you show how frustrated and upset you are, the more they think you're a whacko ....


Oh yeah, totally. Can you imagine if someone took out their cell phone and started filming my meltdown and it went viral on the internet? :lol: Now THAT would have been bad!

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