Update from this post. I don’t know what to do at this point. I’m desperately trying to find a solution. Please someone give me advice here because I can’t deal with Express Scripts anymore. Does anyone know of savings clubs or programs (such as Caremark, GoodRx Gold, etc.) that cover Viibryd?
I keep getting conflicting info from Express Scripts. Basically what I’ve found out is that we’re under a program called Smart90, where they’ll only cover 90 day fills of maintenance meds (so that has nothing to do with the prior authorization, apparently) and will only fill it at certain pharmacies (CVS, Walgreens, or their mail order pharmacy). Here’s the conflicting info I keep getting:
- Regarding my prior authorization, one representative told me it expired on 3/21, another told me it didn’t.
- One representative told me she could put in an override for a 60 day fill, while another rep said she can only do a 30 day override.
- One representative told me they can do an override any time the pharmacy doesn’t have 90 pills, another representative said they can only do 2 of those overrides.
The problem here is the Smart90 program in which they won’t fill fewer than 90 days. The pharmacy doesn’t always have 90 pills. When I went to get my 90 day fill, they only had 35, so I got an override to fill 30. Then, I tried to get the remaining 60 days filled (thinking that would still be covered under the 90 days) and they wouldn’t cover it. That’s when a rep told me she’d put in an override for 60 days, which didn’t go through, so then another rep said they can only do 30 day overrides. I went to get the second set of 30 pills and the pharmacy only had 25.
On Monday they called me again and I said I need a way for fewer than 90 days to be covered and she wouldn’t even try to give me a solution, she just said “we won’t cover that.” I hung up on her. I was sobbing. I’ve never hung up on someone like that before and she kept talking in circles. I know hanging up on people doesn’t do any good but I’m so fed up at this point. I was a wreck. She was so dismissive and nothing she said was even remotely helpful.
I’m at a loss. I’m thinking about dropping my dad’s insurance at this point and exploring independent options but I don’t know how I’d be able to afford it (I’m in school and only will be for another 2 years). I literally don’t care what their reason is for only covering a 90 day fill…no reason they give me has anything to do with the number of pills the pharmacy has on the shelf.
submitted by /u/lizlizliz645
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Update from this post. I don’t know what to do at this point. I’m desperately trying to find a solution. Please someone give me advice here because I can’t deal with Express Scripts anymore. Does anyone know of savings clubs or programs (such as Caremark, GoodRx Gold, etc.) that cover Viibryd? I keep getting conflicting info from Express Scripts. Basically what I’ve found out is that we’re under a program called Smart90, where they’ll only cover 90 day fills of maintenance meds (so that has nothing to do with the prior authorization, apparently) and will only fill it at certain pharmacies (CVS, Walgreens, or their mail order pharmacy). Here’s the conflicting info I keep getting:
Regarding my prior authorization, one representative told me it expired on 3/21, another told me it didn’t. One representative told me she could put in an override for a 60 day fill, while another rep said she can only do a 30 day override. One representative told me they can do an override any time the pharmacy doesn’t have 90 pills, another representative said they can only do 2 of those overrides.
The problem here is the Smart90 program in which they won’t fill fewer than 90 days. The pharmacy doesn’t always have 90 pills. When I went to get my 90 day fill, they only had 35, so I got an override to fill 30. Then, I tried to get the remaining 60 days filled (thinking that would still be covered under the 90 days) and they wouldn’t cover it. That’s when a rep told me she’d put in an override for 60 days, which didn’t go through, so then another rep said they can only do 30 day overrides. I went to get the second set of 30 pills and the pharmacy only had 25. On Monday they called me again and I said I need a way for fewer than 90 days to be covered and she wouldn’t even try to give me a solution, she just said “we won’t cover that.” I hung up on her. I was sobbing. I’ve never hung up on someone like that before and she kept talking in circles. I know hanging up on people doesn’t do any good but I’m so fed up at this point. I was a wreck. She was so dismissive and nothing she said was even remotely helpful. I’m at a loss. I’m thinking about dropping my dad’s insurance at this point and exploring independent options but I don’t know how I’d be able to afford it (I’m in school and only will be for another 2 years). I literally don’t care what their reason is for only covering a 90 day fill…no reason they give me has anything to do with the number of pills the pharmacy has on the shelf.
submitted by /u/lizlizliz645 [link] [comments]Read Morer/HealthInsurance