Or have you ever had this issue and was it ever resolved? For my plan, both medical and prescription expenses go toward the same deductible. I bought 2 prescriptions in January that were bought from an in network pharmacy, prescribed by an in network doctor, and the medication is on the formulary list. There is no way these meds are out of network.
CVS Caremark (the PBM) said that their account is showing that both purchases were in network, that the deductible is paid, and that I’m now in the co-pay phase. However Aetna says their accounts show that all this money went toward out of network and that my deductible has not been met.
Since both medical and prescription go toward the same deductible, these 2 should match, but they dont. Caremark says it seems that their is a glitch with Aetna and they’ve requested Aetna to review my account. So far every time I reach out to Aetna they are completely unhelpful and dont acknowledge that there is a problem.
Anyone had/having this issue? What can I do? I don’t trust Aetna to fix this problem based on how horrible their customer service has been to me.
submitted by /u/pizzunk
[link] [comments]
Or have you ever had this issue and was it ever resolved? For my plan, both medical and prescription expenses go toward the same deductible. I bought 2 prescriptions in January that were bought from an in network pharmacy, prescribed by an in network doctor, and the medication is on the formulary list. There is no way these meds are out of network. CVS Caremark (the PBM) said that their account is showing that both purchases were in network, that the deductible is paid, and that I’m now in the co-pay phase. However Aetna says their accounts show that all this money went toward out of network and that my deductible has not been met. Since both medical and prescription go toward the same deductible, these 2 should match, but they dont. Caremark says it seems that their is a glitch with Aetna and they’ve requested Aetna to review my account. So far every time I reach out to Aetna they are completely unhelpful and dont acknowledge that there is a problem. Anyone had/having this issue? What can I do? I don’t trust Aetna to fix this problem based on how horrible their customer service has been to me.
submitted by /u/pizzunk [link] [comments]Read Morer/HealthInsurance