Sorry for the confusing title, couldn’t figure out how to explain this succinctly!
Basically, I’ve got a medication that I know is definitely covered by my insurance – I’ve confirmed this both through the online medication lookup and by calling them – but when I give my insurance info at the pharmacy, it keeps popping up as not covered.
This is fairly new insurance and it’s only the second time I’ve tried to fill a prescription with it; the first time I had the same issue, but I figured maybe it was just a fluke and that I could just submit the receipt for reimbursement later. This time, the medication was much more expensive so I made absolutely sure it was covered – but the pharmacy kept insisting it wasn’t.
I called the insurance company multiple times, they kept insisting it should be covered, and then finally suggested I go to a different pharmacy (a CVS instead of a Walgreens), even though they said both pharmacies should be fine. But the exact same thing happened at CVS, and when I expressed my frustration to the pharmacist, he tried ringing up a super common drug just as an experiment and sure enough, it was also not covered – so he said clearly there’s an issue with accessing the insurance at all, it’s not about any particular drug. I ended up paying out of pocket (thankfully the pharmacist found me a coupon to help a bit), and I sure as heck better get reimbursed later…
I’m at my wits end with calling the insurance company and just being told over and over that there’s no problem, it must be on the pharmacy’s end. Clearly two separate pharmacies are not both screwing this up, especially after confirming and re-confirming all my info. I was thinking it might be because I’m currently out of state (the insurance is Blue Cross Blue Shield from one state, and I’m in another state) but everyone I spoke to on the phone claimed the prescription benefits should work at in-network pharmacies anywhere.
I know it’s a longshot, but does anyone have any clue what might be going on here?? I’m going to try calling the insurance company back YET AGAIN tomorrow, but I don’t have high hopes…
submitted by /u/randomquestion583
[link] [comments]Sorry for the confusing title, couldn’t figure out how to explain this succinctly! Basically, I’ve got a medication that I know is definitely covered by my insurance – I’ve confirmed this both through the online medication lookup and by calling them – but when I give my insurance info at the pharmacy, it keeps popping up as not covered. This is fairly new insurance and it’s only the second time I’ve tried to fill a prescription with it; the first time I had the same issue, but I figured maybe it was just a fluke and that I could just submit the receipt for reimbursement later. This time, the medication was much more expensive so I made absolutely sure it was covered – but the pharmacy kept insisting it wasn’t. I called the insurance company multiple times, they kept insisting it should be covered, and then finally suggested I go to a different pharmacy (a CVS instead of a Walgreens), even though they said both pharmacies should be fine. But the exact same thing happened at CVS, and when I expressed my frustration to the pharmacist, he tried ringing up a super common drug just as an experiment and sure enough, it was also not covered – so he said clearly there’s an issue with accessing the insurance at all, it’s not about any particular drug. I ended up paying out of pocket (thankfully the pharmacist found me a coupon to help a bit), and I sure as heck better get reimbursed later… I’m at my wits end with calling the insurance company and just being told over and over that there’s no problem, it must be on the pharmacy’s end. Clearly two separate pharmacies are not both screwing this up, especially after confirming and re-confirming all my info. I was thinking it might be because I’m currently out of state (the insurance is Blue Cross Blue Shield from one state, and I’m in another state) but everyone I spoke to on the phone claimed the prescription benefits should work at in-network pharmacies anywhere. I know it’s a longshot, but does anyone have any clue what might be going on here?? I’m going to try calling the insurance company back YET AGAIN tomorrow, but I don’t have high hopes… submitted by /u/randomquestion583 [link] [comments]Read Morer/HealthInsurance