So here is what transpired the past 2 days. Remember- this is the very first time my husband is using his Part D prescription plan.
Yesterday morning I immediately called the doctor's office around 9:15 am and after getting some busy signals I just kept at dialing and finally got through. I got a woman who listened and she confirmed the doctor was working remotely and was currently checking his emails and there was one there about my husband so to just hang tight and wait for his call.
Thankfully, he did call- and wow- what a nice, patient, young doctor! He asked my husband a few questions (they do not have Teledoc set up right now) and he sent in a year's prescription renewal for a 90 day supply at a time to the pharmacy (Hannafords) that I called the previous day where I knew they had the medication. (I had tried to call the mail order pharmacy on Monday since hubby would have a $0 copy- but could not get through or the calls were dropped. Then I went on Facebook and threatened to call the Center for Medicaid and Medicare and the corporate Escalation dept. contacted me but claimed they could not find out if they had the medicine in stock! Said it had to be ordered first! OMG! UGH! I won't even get into it but I know this is not true. Just that there are too many hands and depts and no one knows what they are doing. Meanwhile another drug store only had 30 tablets and he needed 90, so Hannafords it is).
I then called Hannafords just to confirm they received the doctors script and they did and I told them we would pick it up today. Figured we would do our weekly grocery shopping there as well, since it is a supermarket. We get there at 9am when they first open- first ones on a very small line. Pharmacist has it filled and then says it is $55. Wait- what? I asked the pharmacy assistant yesterday when I called if she wanted the insurance info and she said it wasn't necessary right then. (In NY- they would never even fill it without having that info first). Hubby gives the pharmacist his Medicare Part D Wellcare card. She puts all the information in and it gets rejected! Insurance states that he has another provider. What the?! She recommends we call the insurance company to see what is up and she will hold the prescription there for when we come back.
I can't tell you how my anxiety level soared as I have had nothing but problems dealing with this company (and his supplement plan) just to get my husband's insurance set up! I even reported them twice to the Centers for Medicare and Medicaid! Might be a third time!
So we did our shopping and I could not get things I wanted- simple stuff like yeast and flour so I can make bread, napkins. I actually feel like we are in a third world country and I was actually on the verge of crying because of my stress level. That, plus I am still not used to shopping in this store, and with the empty shelves, it took us awhile to get through the store.
On the way home in the car I immediately dialed Wellcare. On hold. Transferred to 3 different departments- get home and while unloading the groceries still on hold. Bottom line- the last agent said she was hooking me into Medicare. The Medicare rep was on a cell phone- I assume working from home or something- and it was very difficult for us to hear her. More stress! For some crazy reason their system had my husband's employer in there so the script was rejected as it thought he had other insurance. I don't get this as he has been retired since 1/1 and had Part A and B and we have a letter from Medicare stating they know he no longer has that employer coverage and has Wellcare and even on hubby's Medicare website it shows Wellcare!!!!!
So that agent, asking us 4 thousand questions- omg- about black lung disease, workers comp and all this BS- they are like robots told to ask all these questions that have nothing to do with anything! We could not even hear or understand her for the most part and we just agreed with whatever she said. Mind you, hubby is very hard of hearing as it is! Anyway, she deleted the information regarding my husband's employer insurance. At least that is what I could figure out as again, we could not hear half the conversation!
So the Wellcare rep was on the phone the whole time with us and the Medicare rep and she put the script claim in right away and it went through. She said to call the pharmacy and make sure they see it as well before we make the trip back. Told us it should be a $0 copay. So- I call the pharmacy and she says yes- it went through! $24! Wait?! What? It is supposed to be $0!
I call the CVS/Caremark (whom Wellcare uses for prescriptions) escalation dept. that I spoke with Monday. Of course, the guy I was on the phone with on Monday is off but I spoke to someone else and she looked up our case and said she will call Wellcare and call me back. Meanwhile, I called Wellcare myself and also went on line to my husband's Wellcare account to make sure the pharmacy is in network.
Well- it does come up on line with lots of other ones. While on the phone, I get disconnected or dropped a few times then finally a rep. and then transferred. That rep keeps checking things. (Mind you every rep we talk to has to verify it is my husband. If we have to repeat the same darn things like our address and phone # one more time we are going to scream!)
She finally gets back on the phone. Come to find out the only "preferred" pharmacy here is Walmart. The information given me by the other rep was wrong as Hannafords is not a preferred pharmacy. On line, all the pharmacies that come up are "retail" and since only Walmart is preferred, I probably did not notice that it is marked next to the Walmart name (the only one with that mark) and not the others. They actually even have Osco listed as preferred and they have been out of business for awhile now. So yes- he has to pay $24. She also transfers me to the mail order dept thinking maybe I should not have been asking the pharmacy dept about the availability of the medication and I ask THAT rep about the drug being in stock. She is checking- taking forever!- and then- wala!- the call is dropped!!!! OMG! I give up.
So total of 2 HOURS on the phone with this! The whole morning gone! More of my life- gone!
I call Walmart. The pharmacist tells me she only has like 20 pills left but could order them and maybe even have them tomorrow. I tell her that's ok. At this point we know Hannafords has them and will pay the $24 this time. With all the craziness going on with the corona virus, "a bird in hand...." I send hubby back to Hannafords to get the medication. Just pay the copay this one time and we will deal with it- ugh- again in a few months. (When he worked, he had CVS/Caremark also through Aetna and the copay was $12 for 3 months).
We can always have the prescription transferred to Walmart in the future. First choice would have been mail order if we knew they had the drug or not. So much for the $0 copay BS.
Oh- and then the Escalation dept. finally calls me back and tells me Hannafords is not a preferred pharmacy. I tell her I found that out already and my big issue with CVS/Caremark is there should be a way to find out if a drug is in stock or not.
Now I just received a call from someone else at CVS/Caremark and said they do have the medication in stock. Well- too late. She gave me her name and direct extension (like 7 digits long!) and said next time if Walmart does not have it and we want it mail order to call her two weeks ahead and let her know and she will send an email out to the correct dept to find out and let me know. Of course, in that scenario hubby would have to have the doctor send another script- this time to CVS/Caremark mail order. SMH.....
Why any person should have to go through all this for one simple med. order is beyond me. It just never ends.
So more of my life energy wasted on this healthcare cr^&p and this has nothing to do with the pandemic. This is how it has been even before this. Really you can't make this sh0)&^t up! I have had it! What an ordeal. And another day wasted.