topic Re: Preciption Coverage Change without out knowledge in Wellness

Preciption Coverage Change without out knowledge

I am still oxox — Thu, 11 Jan 2024 19:50:42 GMT

All of a sudden at the end of the year we get a letter from our health insurance that our Prescription Plan will now be handled by Silver script.We have had the same coverage for about 10 years and didn't want to change. so we opted out but the change did not take affect I only found the out when I tried to have my scripts from CVS delivers and was told we had no insurance. This was Monday, I called the plan and found out what was going on and it took a few days to change back to the plan we had. annoyance that was really not needed or wanted. Thank goodness nothing was urgent

Re: Preciption Coverage Change without out knowledge

Kachina624 — Thu, 11 Jan 2024 20:43:22 GMT

@I am still oxox. Did the coverage change or was it just the provider? My provider also changed January 1st, but the coverage stayed the same,

Re: Preciption Coverage Change without out knowledge

I am still oxox — Thu, 11 Jan 2024 20:53:37 GMT

@Kachina624 Neither we were able to stick with out old plan, but I I have not acted both would hf changed.

@Kachina624 wrote:
@I am still oxox. Did the coverage change or was it just the provider? My provider also changed January 1st, but the coverage stayed the same,

Re: Preciption Coverage Change without out knowledge

On It — Thu, 11 Jan 2024 22:07:44 GMT

@I am still oxox I am glad you were able to get the insurance corrected and back to your chosen plan. Staying on top of everything especially this time of year is a challenge.

Re: Preciption Coverage Change without out knowledge

HLP — Fri, 12 Jan 2024 08:08:37 GMT

@Kachina624 wrote:
@I am still oxox. Did the coverage change or was it just the provider? My provider also changed January 1st, but the coverage stayed the same,

Last year my provider changed, and was told they bid on providing medicine. It's annoying but was handled pretty good by asking the one place to please send the scripts over to the other place. This should automatically have been done, but I don't think people like to be outbid.

Re: Preciption Coverage Change without out knowledge

Trailrun23 — Fri, 12 Jan 2024 21:46:28 GMT

I got a letter a few days before Jan 1 saying my scripts would change from Silver Scripts to Express scripts. No other option if I stay with pension provider. They have rejected my drs appeal letter. I think it should be my MD who decides what I need to take, not the insurance pencil-pushers.

Re: Preciption Coverage Change without out knowledge

deepwaterdotter — Fri, 12 Jan 2024 23:54:34 GMT

We used Express Scripts as our pharmacy provider for many years until our former employer moved us to a different company. We were very satisfied with Express Scripts and never a problem with new scripts or refills.

Re: Preciption Coverage Change without out knowledge

Tinkrbl44 — Sat, 13 Jan 2024 21:03:03 GMT

@Trailrun23 wrote:
I got a letter a few days before Jan 1 saying my scripts would change from Silver Scripts to Express scripts. No other option if I stay with pension provider. They have rejected my drs appeal letter. I think it should be my MD who decides what I need to take, not the insurance pencil-pushers.

@Trailrun23

Did they just reject the prescription or were there alternative meds suggested?

I would contact the insurance company and make a very strong complaint. The squeaky wheel gets the grease.

Re: Preciption Coverage Change without out knowledge

Effie54 — Sat, 13 Jan 2024 21:06:24 GMT

I think @cheriere had the same issue last week. It sounds frustrating to say the least.

Re: Preciption Coverage Change without out knowledge

cheriere — Sat, 13 Jan 2024 21:35:59 GMT

@Effie54 I just wanted to let you know about my pharmacy trip today. I'm soooo THANKFUL!!! Whenever I got there to pickup my two prescriptions, including the one that cost over a thousand dollars, they were both covered! I couldn't believe it! I paid under $10 for the two of them. Either my dr really was on the ball and got this other company to pay or it automatically covered it!

What a load this has taken off my mind...at least for the meantime. Now, I'm wondering if I should stay with the coverage Medicare assigned lol. I did receive a letter in the mail from my old insurance carrier today. It said the coverage wouldn't go into effect until February 1, but I still didn't receive a bill or instructions how to pay.

Re: Preciption Coverage Change without out knowledge

cheriere — Sat, 13 Jan 2024 21:47:12 GMT

@I am still oxox I'm so very sorry to hear you're going through this with your prescription insurance. I recently had the exact same thing happen. I received a letter in November letting me know I'd have to pay a little extra and to call if I wanted to keep the same insurance or I'd be assigned a different one. I called immediately after but somehow they claimed it was mishandled and I was disenrolled.

I would have been just like you at the pharmacy not knowing had it not been for a fluke that I decided to call. That's when I was told this information in early January. After 3 hours on the phone, I was able to re-enroll but this coverage won't go into effect until February 1st. Until then, I'm supposed to use this other insurance. However, I have to go through the trouble of having ALL my expensive meds that require approval all re-approved etc. It's really been a nightmare.

I really hope and pray everything goes well for you and there's no disruption in receiving any of your medications. I don't know what's going on with these plans this year, but it's causing a lot of people much unnecessary stress. If I can help in any way please just let me know. ❤️

Re: Preciption Coverage Change without out knowledge

I am still oxox — Sat, 13 Jan 2024 21:48:58 GMT

@cheriere thank you and everthing was resolved within a few days it was just annoying and I am glad I saw the letter. Otherside I would of been in for a big suprise

@cheriere wrote:
@I am still oxox I'm so very sorry to hear you're going through this with your prescription insurance. I recently had the exact same thing happen. I received a letter in November letting me know I'd have to pay a little extra and to call if I wanted to keep the same insurance or I'd be assigned a different one. I called immediately after but somehow they claimed it was mishandled and I was disenrolled.

I would have been just like you at the pharmacy not knowing had it not been for a fluke that I decided to call. That's when I was told this information in early January. After 3 hours on the phone, I was able to re-enroll but this coverage won't go into effect until February 1st. Until then, I'm supposed to use this other insurance. However, I have to go through the trouble of having ALL my expensive meds that require approval all re-approved etc. It's really been a nightmare.
I really hope and pray everything goes well for you and there's no disruption in receiving any of your medications. I don't know what's going on with these plans this year, but it's causing a lot of people much unnecessary stress. If I can help in any way please just let me know. ❤️

Re: Preciption Coverage Change without out knowledge

cheriere — Sat, 13 Jan 2024 21:52:07 GMT

@I am still oxox Thank goodness! It broke my heart for you whenever I first saw your post. I thought, Oh No, this is happening to someone else here now. I'm really glad everything is straightened out for you.😊❤️

Re: Preciption Coverage Change without out knowledge

Effie54 — Sat, 13 Jan 2024 22:10:28 GMT

@cheriere wrote:
@Effie54 I just wanted to let you know about my pharmacy trip today. I'm soooo THANKFUL!!! Whenever I got there to pickup my two prescriptions, including the one that cost over a thousand dollars, they were both covered! I couldn't believe it! I paid under $10 for the two of them. Either my dr really was on the ball and got this other company to pay or it automatically covered it!

What a load this has taken off my mind...at least for the meantime. Now, I'm wondering if I should stay with the coverage Medicare assigned lol. I did receive a letter in the mail from my old insurance carrier today. It said the coverage wouldn't go into effect until February 1, but I still didn't receive a bill or instructions how to pay.

@cheriere I'm so happy that your part D carrier paid for your prescriptions! That must have been a huge relief! That's a good question; whether to keep what carrier they assigned you, or go back to your previous carrier. Here's what I might try; I would either look up the prescriptions on the new part D carriers formulary to see if your prescriptions will be covered from here on in, or if it was a one time courtesy. Then I would look at the price per month difference between the one they assigned you and your old carrier. I know for me, UnitedHealthCare was wayyyy more than Aetna. I was glad I dropped UHC. They were a royal pain to deal with. Aetna customer service is amazing. You want to be sure which ever part D carrier you choose covers your monthly prescriptions at the very best rate, with the lowest copayments possible. I think that's how I would choose. I'm so glad you had a good experience at the pharmacy. 💖

Re: Preciption Coverage Change without out knowledge

cheriere — Sat, 13 Jan 2024 22:30:12 GMT

@Effie54 Boy was I relieved! You wouldn't believe the stress that simple thing seem to take off my mind. You give very good advice. I was thinking along those lines.

I'm gonna go through the medication coverage book they sent this weekend. Monday I'll call my drs office and ask whether or not they had to get the medication authorized and what the company had to say. Then, I'll call the insurance company and find out about each medication that required approval from the other company. I do know this new comp only charges a maximum of around $5 for brand name medication...but many might require approval. Like you said, this could have been a courtesy fill today.

I have to remember to find out each yearly deductible as well too. I don't want to end up switching back to my old plan only to end up paying more for everything lol. I'll be so glad to have all this sorted out and behind me. But tonight I'm gonna catch up on reading here in the forum and maybe watch a movie. I've not been able to read much here in the last couple days and I feel as though I've missed out on all kinds of good conversations 😃.

I can't thank you enough for being so kind, helpful and supportive to me during all this. It really means a lot to me. 😊❤️💕

Re: Preciption Coverage Change without out knowledge

Effie54 — Sat, 13 Jan 2024 22:34:54 GMT

@cheriere wrote:
@Effie54 Boy was I relieved! You wouldn't believe the stress that simple thing seem to take off my mind. You give very good advice. I was thinking along those lines.

I'm gonna go through the medication coverage book they sent this weekend. Monday I'll call my drs office and ask whether or not they had to get the medication authorized and what the company had to say. Then, I'll call the insurance company and find out about each medication that required approval from the other company. I do know this new comp only charges a maximum of around $5 for brand name medication...but many might require approval. Like you said, this could have been a courtesy fill today.

I have to remember to find out each yearly deductible as well too. I don't want to end up switching back to my old plan only to end up paying more for everything lol. I'll be so glad to have all this sorted out and behind me. But tonight I'm gonna catch up on reading here in the forum and maybe watch a movie. I've not been able to read much here in the last couple days and I feel as though I've missed out on all kinds of good conversations 😃.

I can't thank you enough for being so kind, helpful and supportive to me during all this. It really means a lot to me. 😊❤️💕

@cheriere You're so very welcome. I'm happy to help. You're right - the deductible is also something to consider. When you get all the info from the doctor's office and insurance companies, it will be easier to decide which carrier is best. It's hard to keep getting approvals for medications as well. But a $5.00 co-payment is pretty good. We're here for you anytime. 💖