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The New PBM


Rower Michelle

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ARRG!  My insurance company changed pharmacy benefit managers AGAIN.  This is the third one in 9 months.  Aside from the usual hassle of getting set up in the system, this new PBM is a special source of frustration!  Each of the previous PBM's mailed my targeted therapy on an ice pack.  The first go round with the new company, the meds were delivered in a cardboard box in 110 degrees. NO bueno, they had to eat the $15,000 and ship a new bottle overnight.  This month, trying to be proactive, the customer service agent became combative and then assured me the meds will be shipped with the cold pack.  Lo and behold, this morning no cold pack.  How does the insurance company respond?  They are arguing with me about shipping temperatures.  I'm two days into this drama and 5 1/2 hours on phone work so far and no plan for refill---yet.   

In two months, this insurance company has blown $30K on mishandling of meds, and we wonder why our premiums are so outrageous.   Just figured I'd let out some steam while listening to what is arguably the worst muzak I've ever heard.   So the fight will continue.....   

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Sounds like the one I have. Wanted me to take oral pain meds instead of numbing cream for the port. Paid for brand name inhaler instead of generic. Rx benefits managers are worse than dealing with medical insurance companies. The people who answer the phones are clueless. 

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Having trouble with your insurance is probably the worst.

Sorry to hear they are messing up your meds. While they keep screwing around you are getting all out of wack with your treatments.

Ought  to be a special place in hell for insurance people.

Hang in there Michelle. I will say an extra prayer that they get it straight soon.

Ron

 

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Michelle,

This is what some companies do that earn the the titles of "bloodsuckers".  Sorry to hear this, but I'm pretty confident they don't know who they are dealing with in you.  If I were them (and knew you) I'd be putting two cold packs in.  :)

Lou

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Lou- 

That’s hilarious!  Yes. I did make a BIG stink. I filed a complaint with my employer, a grievance with the insurance company and blasted them in the follow up email survey. Just as I was drafting a complaint to the Joint Commission of Healthcare & the state attorney general, they cried uncle.  I now have a single point of contact to manage my refills going forward. It’s a nightmare start up as this go-to contact doesn’t have a voice mail set up yet.  Yikes!  All I want is a simple process to refill my meds without any hassles.  So the story goes.  Oh well. Onward!

Michelle

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Well done Michelle! When I make a stink, I, unfortunately, receive an email that’s less than stellar. 🤷‍♀️ It’s called being on top of things and I commend you!!! (And myself, I might add) :)

xx

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It stinks that it has to come down to making a big stink and filing complaints on top of taking care of yourself. But It sounds like you are one gal not to mess with. 

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13 hours ago, Moonbeam said:

Well done Michelle! When I make a stink, I, unfortunately, receive an email that’s less than stellar. 🤷‍♀️ It’s called being on top of things and I commend you!!! (And myself, I might add) :)

xx

Keep advocating Moonbeam! The healthcare system is broken.  Just remember, it's not us, it's them.  Props to you too!  We've got to make some noise to keep these folks on their toes!! 

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So far my drugs are just cheap drugs.  I don't have drug insurance.  I don't know what costs $15k, but I'm sure I will run into it before this is over. Luckily I qualify for Medicare in Dec.

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Hi Terri, 

You might want to check out AARP, I saw their last month their magazine had a feature on how to save on drug costs if you do not have Medicare Part D. It's worth checking out.  (I still can't believe I'm old enough for AARP- I used to think that was for serious geezers......).  

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