1. by way of catharsis and to seek sympathy bc I'm outraged. This among all the other fights we have to deal with. Its sooo ridiculously hard!!!!
2. I want to know if there are others who have had similar problems with this particular company. If I find a number of folks w problems with this company perhaps I can pitch the story to some journalists.
Here's my story:
This December one of my beloved (now deceased) LLMDs worked hard to get my drugs approved through my pharmaceutical company--MEDCO. They do the approval. Once approved I can either pick it up at my local pharmacy or have it shipped by mail from Medco. I only use my local pharmacy--never the mail. I use the local pharmacy because i know the staff, the staff knows me (all too well!) and they actually care about my well being. It has never made sense to me to go with some distant system that is all about voice mail and no personal touch. So many times in dealing with the ups and downs of this illness it has made a difference working with my pharmacy staff who care enough to go to bat for me. Nobody at Medco will ever know or care if I'm sick or if I were to die. My pharmacy staff do and would. In December, when I tried to get my meds, the local pharmacy was unable to dispense because the system showed that they had been mailed to me. When I called Medco they said yes they were mailing. I said no don't. I don't authorize that. I do NOT want medications by mail. For multiple reasons including the fact that anything left on my porch won't be here when I get home. (There is active drug dealing in the neighborhood where I live. My planters even have been stolen off my porch) It is impossible for me to receive a package at the home address which is where they said they mailed it. After days and days of fighting I got a supervisor to authorize that I could pick it up at the local pharmacy....but she said the mail had already gone out and she couldn't stop that. She said she would in addition authorize local pick up. I happily went back to my pharmacy and picked up my meds for my usual copay of $20 per prescription or a total of $40 for two prescriptions. I never thought twice about the prescriptions that were allegedly mailed. I never received anything by mail...except a great surprise when the bills started coming. Yup! now I am receiving bills from Medco for three times the copay rate for the two prescriptions that I picked up at my local pharmacy where I have picked up every single prescription for this illness over the last 4.5 years. Medco says I owe $120 for the two prescriptions that I expressly did not authorize them to mail and for which I spent agonizing hours on the phone with supervisors trying to get them NOT to send. Since the bills started arriving I've called their "problems resolutions" line three times and left three messages. I have never received a single return call. Now they are sending me notices that say "previous atttempts to collect the balance due have been unsuccesful" Total outrage!!!!!!! They are clearly about to send this off to collections without ever returning my call, for an amount that is triple the normal copay rate (I paid $40 for the same thing at the local pharmacy), and for medications that I begged them not to send and which I never received!!!
Anyone else out there had to deal with Medco?
Curious if there is a predatory pharmaceuticals story to pitch.
Thanks Pom
[ 07. April 2007, 03:31 PM: Message edited by: pomegranite ]
Posts: 309 | From CA | Registered: Nov 2002
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posted
Document everything, including dates and times you called to resolve the problem, etc. Forward the information to your state Atty General, if they can investigate credit card practices, they can also investigate pharm practices. also see if your local bar assn has a pro bono group, to help push this and resolve for you .
Posts: 116 | From Plano, Texas, USA | Registered: May 2004
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posted
We had problems with Medco in the past. When you talk to someone on the telephone always write down the date and time, and get the persons name. Also get and account or shipment number, or reciept number on everything. I have found that if they make a mistake you have to catch them at it and prove it.
I'm so sorry for your problems. It's hard to have difficulties with an uncooperative comapany, but it's worse when you don't feel well.
Posts: 663 | From NH USA | Registered: Sep 2004
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posted
Do you know anyone at your insurance company? Doesn't Medco just act on behalf of the insurance company? Maybe your insurance company could call someone at Medco to help resolve this.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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quote:Originally posted by seibertneurolyme: Maybe your insurance company could call someone at Medco to help resolve this.
Bea Seibert
Good idea!!
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96223 | From Texas | Registered: Feb 2001
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Greatcod
Unregistered
posted
Actually, Medco is a Prescription Benefit Management thing...not a Pharma or an Insurance company...but these kinds of organizations will be using IDSA Lyme guidelines in the future to control costs, especially I think with Medicare D. In my case, they are Healthnet, and they would be in charge of OKing IV antibiotics for my Lyme. My guess is that they would approve of a one time single month of IV for a diagnosis of neuroLyme. They pay very close atterntion to guidelines to control costs (and their profit, of course). Probably another topic--sorry.
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GreatCod ...you are correct. They were very intense about limiting my IV to 4 weeks after initially approving 6..they then only paid 4 (new IDSA guidelines came out during my first 4 weeks). I appealed many many times (more than you are technically allowed...but was able to have them re-look because they hadn't considered all documents.) Every time they quoted chapter and verse the IDSA guidelines and research that went into those like Klempner. I put together a very very thorough case and have experience in my own work past w succesfully appealing things on behalf of patients with special needs---but there was no budging them on this. One of my LLMDs even told me how well I'd put the case together.
Good luck! Pom
Posts: 309 | From CA | Registered: Nov 2002
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