New Blue Cross Fed drug program snafu

patbz · ‎03-10-2010

DH takes a tier 4 drug monthly and we had no copay until Jan24 when it went to $60 A month! ( so he stopped taking drug on principle). Talked to CVS mail order pharmacy about "why" and finally figured out it was our insurer (BC Federal). Called BC and found out its due to their new pharmacy program they wanted us to enroll in during open season. TG we have the option to disenroll in said program ( on back of insurance card the Pharmacy has a recording just to disenroll...). Passing this on in case anyone else on BC takes a tier 4 drug.

Desert Lily · ‎06-24-2011

One reason for the increase in Rx insurance premiums & Rx costs is that there will be a cap of $2,000 for out-of-pocket Rx costs. This is a change.

For example, some people's drug out-of-pocket $ could be $4,500 or higher if there wasn't going to be that cap.

The other people will need to make up the $ gap by paying higher premiums & drug costs to help cover the $2,000 out-of-pocket cap for those whose out-of-pocket $ could've been higher.

Kachina624 · ‎03-10-2010

@patbz. My group also changed to an outfit called Express Scripts (who ever heard of them?), and it seems to me like the co-pays went up. We had Optum RX and they were so good. This new group doesn't even offer non-childproof caps. I had to take a hammer to one bottle. They've already screwed up one of my meds.

New Mexico☀️Land Of Enchantment

Q-Checker · ‎05-09-2010

Fed BC recently offered the opportunity to enroll in Medicare Part D for drug coverage. Is that what you are referring to? Fed BC enrollees were offered the choice, as described in a letter sent to all enrollees, to stay with their BC plan for med's by submitting the enclosed form (or by calling the designated phone number) to decline the offer for Medicare Part D. This information may also have been sent to enrollees by email. l don't think it is a good idea to stop any prescribed med "on principle." This should be a medical decision, which is best discussed with the prescribing physician, who may offer an alternative med or another solution. The medication was prescribed for a reason, not a whim.

skatting44 · ‎07-26-2019

@patbz @Q-Checker

The problem with FBCBS was that they automatically enrolled all those over age 65 into the Medicare Part D Program Before asking any of their enrollees what they wanted to do . An enrollee had to opt out before Dec 31 or later had to submit request in writing .

SaveTheTurtles · ‎10-09-2023

@Kachina624 wrote:
@patbz. My group also changed to an outfit called Express Scripts (who ever heard of them?), and it seems to me like the co-pays went up. We had Optum RX and they were so good. This new group doesn't even offer non-childproof caps. I had to take a hammer to one bottle. They've already screwed up one of my meds.

I have heard of Express Scripts as my dad was moved from Caremark to Express Scripts. I now have Optum RX for mine and had never heard of them before. They have been awesome so far. Glad my plan changed mail order companies.

patbz · ‎03-10-2010

@skatting44 : We will fax them a request to return to standard program; will be effective one week later. Interesting that insurance card has a pharmacy phone # ( when I called it was a recording on how to go back to standard program; no " leave a message"). DH will be back on his skin condition med within 2 weeks.

Carmie · ‎10-25-2010

Blue Cross has nothing to do with your insurance benefits. They only administer insurance for Federal employees.

The Federal government chooses their benefits. They do offer a few different insurance policies and you get to choose every year during the open enrollment period.

The information is given to you to make your choice. It is your duty to read the material.

If a tier 4 drug costs you $60, that's a great price. Most other RX programs have a copay higher than that for tier 4 and they require preauthorization. Tier 4 drugs can cost you thousands without insurance.

debfau · ‎03-25-2010

@SaveTheTurtles wrote:
@Kachina624 wrote:
@patbz. My group also changed to an outfit called Express Scripts (who ever heard of them?), and it seems to me like the co-pays went up. We had Optum RX and they were so good. This new group doesn't even offer non-childproof caps. I had to take a hammer to one bottle. They've already screwed up one of my meds.
I have heard of Express Scripts as my dad was moved from Caremark to Express Scripts. I now have Optum RX for mine and had never heard of them before. They have been awesome so far. Glad my plan changed mail order companies.

Note that Express Scripts is owned by Cigna (Insurance Co) and Optum RX is owned by UnitedHealth Group (Insurance Co); so each Insurance company has their own mail order pharmacy.

Carmie · ‎10-25-2010

@Kachina624 wrote:
@patbz. My group also changed to an outfit called Express Scripts (who ever heard of them?), and it seems to me like the co-pays went up. We had Optum RX and they were so good. This new group doesn't even offer non-childproof caps. I had to take a hammer to one bottle. They've already screwed up one of my meds.

I have had Express Scripts for close to 30 years. They are a huge RX company with growth continuing every year.

They also have a warehouse in my area, so they are quite popular around here.

I don't take meds so I only had to deal with them personally a few times with no issues.

The health insurance company I worked for used them as their mail order pharmacy.