My pharmacy benefits are through a carrier called Prime Therapeutics, and boy are they a pain. I know they're supposed to be maintaining the same "high standards" in customer service that were are required to, such as: checking back with the caller every 2 minutes, anticipating needs to prevent call backs, and quoting the correct information.
I received my prescription in the mail this afternoon for Clomid. I drove to my usual pharmacy, Shopko, and while in the parking lot I decided to call my insurance to verify what my copay will be. If it is name brand it is $45 and generic is $15. Well I got a guy on the phone who asked my information twice, as though he wasn't listening, and then when I told him the medication and dosage he told me it would be $71.89, so I asked if the insurance is covering a percentage at all? It didn't look like it, so he had to put me on hold. It was 5 minutes before he came back to tell me he was still looking into it. Then another 15 minutes straight on hold, and he comes back to tell me that it's a specialty drug that has to be filled at a specialty pharmacy to get any coverage at all and it would be an $11 copay. Well.. that wouldn't work since I'd have to get the rx to the specialty pharmacy for them to send it, and mailing time... yea not likely to have it in hand Monday!! So... I go in to Shopko and give them the rx and ask them what they were charge. After waiting for another 15 minutes I find out it's only $29.90. ?? Ok fill it! My insurance told me they wouldn't cover it unless it was through a specialty pharmacy and without it it'd be $71. So they filled it while I waited. When it was ready it turned out the insurance did cover it and it was my generic copay of $15. OY!! The headaches of dealing with insurance. I know I give much better service than I received and that always bugs me too.
Atleast it all turned out for the better in the end, but just another frustration. Upcoming will be dealing the financial aspect of going through treatment and missing work. UGH! I hope it'll be worth it in the end and we'll be successful.
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