Prescription Runaround

In a previous post, I wrote about changes to our health care plan this year. My former employer quit offering group health insurance to retirees. Instead they funded a healthcare reimbursement account and I was on my own to find a plan on the healthcare exchange. The result was a plan that costs triple what I paid in 2016 and essentially leaves us self-insured for the first $13,100 – we’re really only covered for a catastrophic event.

Our previous health care coverage also included prescription medications under a plan through CVS-Caremark mail-order pharmacy. When I looked at the healthcare exchange, I wasn’t too thrilled with the prescription coverage and cost. I called CVS-Caremark to inquire about retaining the plan. I have a few medications that I take on a daily basis. CVS-Caremark told me there were no changes in my prescription plan, prescriptions would continue to be mailed every 90 days. Now that was good news.

In February, they mailed me my prescriptions. Then in March, they sent me an e-mail telling me that I was no longer enrolled in their plan, my previous employer had terminated the coverage. Now I had a problem. I already enrolled through the healthcare exchange and adding prescription coverage would be problematic.

After looking at a few options, I decided to buy my medications out-of-pocket through the AARP discount mail-order plan. I spoke with their customer service and was told I needed to download a form from their web site and send it in along with written prescriptions from my doctor to start the service.

I obtained the written prescriptions and completed the form – including credit card payment information and mailed it to them about 10 days ago. Yesterday I checked my account on their web site and no prescription order was showing. So, I called their customer service again. After the usual automated phone system runaround, I spoke to a representative.

When she found my information, she told me they had the paperwork and prescriptions but I hadn’t asked them to actually fill the prescriptions – what!? I had filled out their form completely and followed all of their instructions. Maybe it’s just me, but I figure that when I drop off a prescription at a drug store, it’s understood that I want the prescription filled. When I sent in the form including billing information it should be de facto evidence of me ordering the prescriptions. After more than 30 minutes of runaround, giving them all of the information that was on the form I sent in, she finally told me the order would be filled. I should expect the meds by April 13th. Whew!

A couple of hours later, my phone rang. I picked up the call and it was a recorded message from OptumRx – the supplier for the AARP discount plan – telling me there was a problem and I need to stay on the line for a representative. I was on the phone listening to their music and recorded messages for 20 minutes before a representative came on the line. She looked up my account and said she needed to verify some information.

We went over all of the same information that was on the form I sent in and also gave to the representative a couple of hours earlier. She put me on hold several times – once for 15 minutes. After 41 minutes on the phone, she told me she had everything she needed to fulfill my order – I hadn’t given her any new information at all, we just repeated everything they already had. After this call, I got a confirmation e-mail, so maybe that’s a good sign and things are moving along as they should. They also sent a link to complete a satisfaction survey. Oh boy – this will give an opportunity to tell them what I really think.

On Wednesday evening, Donna prepared some chicken breasts she bought at WinCo Foods. She spiced them with a green chile BBQ rub that she bought when we were in Taos, New Mexico. I cooked the chicken on the Traeger. About 15 minutes before I took them off the grill, I basted them with Pomegranate and Mango Chipotle Sauce. The combination was excellent, giving the chicken a spicy-sweet flavor.

Green Chile Spicy BBQ Rub

Pomegranate & Mango Chipotle Sauce

Chicken breasts hot off the Traeger

Donna served it with steamed asparagus and garlic smashed potatoes. Once again, I’m dining like a king! We sat outside and enjoyed the meal al fresco.

A meal fit for a king

Yesterday Donna joined me for pickleball in the morning. She took a fall in her first game and scraped her knee and shin. But she hung in there and we played several games. This morning I played again for the fourth straight day, but Donna woke up feeling a little punky with a sore throat, so she passed.

The temperature should reach the upper 80s today and tomorrow, so it looks like we’ll be running the air conditioners again.

One thought on “Prescription Runaround

  1. Maryann

    I’ve always wondered what plan you ended up getting for your insurance. We haven’t been impacted much with the ACA change as we are retired and have retiree insurance that we pay for, but your story has really bothered me since reading it. It is so wrong that you should have to pay that amount. As I recall when the Obamacare went into effect in NM they said that in 2017 the price would really be going up. Almost half the population of NM is on Medicaid! A friend’s son, who is a divorced father, can’t afford the ACA insurance, so now he has to also pay for not getting it. WHAT!

    Good luck with you insurance/drugs/etc.. Please write about this on your blog though as I’m very interested.
    Maryann

    Reply

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