"Federal Healthcare Programs"

[dsneprincess]

It doesn't really have anything to do with what your premiums are & how they compare. It has to do with the federal government's rules & what they allow. All insurers set there own regulations that the providers either agree to accept and abide by, or they don't and can't take that insurance. Everyone plays by the same rules, which is why you pay $x for brand names or doctors visits, no matter what the actual fee schedule is; insurance contract dictates the price. Some items are set at a loss; some aren't. Usually, it is a decision of whether you lose more business accepting or not accepting the insurance, most recent example is Walgreens and Express Scripts. Federal regulations and contracts cover government employees, Medicaid & Medicare....if you violate on any one of these, you are excluded from all, probably forever.

In some states, state board regulations won't allow reward points on ANY pharmacy purchases in these programs, cash or insurance anyway. The "reward" programs reward the store more than the consumer anyway! Am I the only one wishing that stores just had "sale" prices for everyone & I didn't need 7 bazillion cards to carry for every store I shop! I used to enjoy shopping, now it's one more chore. (& they send me TONS! of jjunk email daily that I have to sort through!)

 

[mrsklamc]

Target is suppose to call me back Monday but I don't expect anything good. I do plan to lodge a complaint. Especially since they signed me up at the pharmacy, and they should have known/ informed me about my insurance. It's clear it's federal on my card

They should have told you, but as far as lodging a complaint about not getting the rewards- that's the law, not Target.

 

[RCBA]

Sharon we pay quite a bit more than we did privately as well. I also know people pay more then we do now. It just seems to be broad stroking federal employees. I understand federal programs not being included and even Trieste. But we pay and have the same setup as everyone else. Why wouldn't I expect to get the same rewards as others?

It makes me sad. Target is suppose to call me back Monday but I don't expect anything good. I do plan to lodge a complaint. Especially since they signed me up at the pharmacy, and they should have known/ informed me about my insurance. It's clear it's federal on my card

They may have signed you up because not all Rx's are ran through your insurance. I'm on a $4/mo med and it does not go through my insurance. Another med I take is not covered by ins so I pay the retail price.

 

[Leajess99]

Question-- there's all these AWESOME prescription-transfer incentives out there, but they all say they exclude "any prescription paid for in whole or in part by state or federal healthcare programs."

Anybody tried this with Tricare/Healthnet? I mean, we're federal employees, but I *THINK* it's a private company, yes/no?

Obviously this makes sense that if something is funded by the government directly, then incentives are kickbacks/bribes, and therefore illegal... but is Tricare a "federal healthcare program" or are they talking more for medicaid-type programs?

Tricare and CHAMPVA and such are considered federal healthcare programs and keep you from the incentives. It stinks because some of us still have to pay for the meds with the programs but they do not care. I am so glad my younger 2 are coverd by their dad's insurance first and CHAMPVA last.

 

[sookie]

Question-- there's all these AWESOME prescription-transfer incentives out there, but they all say they exclude "any prescription paid for in whole or in part by state or federal healthcare programs."

Anybody tried this with Tricare/Healthnet? I mean, we're federal employees, but I *THINK* it's a private company, yes/no?

Obviously this makes sense that if something is funded by the government directly, then incentives are kickbacks/bribes, and therefore illegal... but is Tricare a "federal healthcare program" or are they talking more for medicaid-type programs?

When I had federal blue cross / blue shield because I was a federal employee, the pharmacy could not use any of those promotions. That was crummy! It wasn't like I was on a state welfare program! I paid a lot of money for my insurance! Blah!
So yes, Tricare would be the same way my friend.

 

[2girlsmommy]

I think it depends on the store. When I transferred our tricare prescriptions to Meijers with a $20 gift card coupon...the tech said that it wouldn't apply since tricare is govt. but, she tried scanning it and it went through...
I don't tank tricare is a govt program like Medicaid etc. my husband put his life on the line and earned those benefits for us...

 

[Local_Girl]

We've had success at Meijer also, and DH is fed BC/BS. I do think it depends on the store.

 

[jsmith]

it does not depend on the store-its federal law-and Meijer will eventually pay the price.

 

[Betsy82]

it does not depend on the store-its federal law-and Meijer will eventually pay the price.

This.

If/when they are audited, they will be fined for giving incentives to those not legally eligible.

We have FEHB insurance. It's significantly less than insurance was in my private sector job. We are just grateful for the excellent coverage and fill our scripts wherever is most convenient.

 

[JB2K]

my husband put his life on the line and earned those benefits for us...

As did I...but...

...although your husband rightfully earned your benefits, who do you think is funding those benefits? The American Taxpayer, that's who.

With that said, it's common practice for all retailers not to offer pharmacy incentives/bennies with those prescriptions being funded by either Tricare, CHAMPVA, or FEHB. In fact, it's federal law.

I have seen some posts regarding Meijer -- if a random store/checker chooses to do this for someone, the company will have to deal with Uncle Sam, eventually, and that could trickle-down to local store management all the way to that checker (is giving someone a small discount/perk they weren't supposed to get worth losing their job over?).

And for the poster who mentioned Target -- if you wish to lodge a complaint, I suggest you do so with your local representative in the U.S. Congress, since they are the lawmakers (Target was only abiding by the rules given to them).

 

[mrsklamc]

I think it was Walgreens that had to pay a great deal of money to a pharmacy technician as a 'whistleblower' since they had been giving giftcards to tricare members against federal law....Here it is:

http://www.justice.gov/opa/pr/2012/April/12-civ-505.html

So yes, Meijer will find themselves in trouble if they don't put an end to this.

 

[mrsbornkuntry]

I think it depends on the store. When I transferred our tricare prescriptions to Meijers with a $20 gift card coupon...the tech said that it wouldn't apply since tricare is govt. but, she tried scanning it and it went through...
I don't tank tricare is a govt program like Medicaid etc. my husband put his life on the line and earned those benefits for us...

I'm sorry, but I have to comment on this. It is a huge pet peeve of mine when people play the "I deserve such and such because I or my spouse puts their life on the line..." card. It's his job. While we enjoy the perks of military discounts, Tricare, MWR events, etc. in all honesty it is what they signed up for. I know when my husband signed up it wouldn't have been a dealbreaker had he known that I would not be able to get pharmacy rewards because we had Tricare (and now BCBS). He likes his job and the perks are an added bonus, not an entitlement.

 

[LadyBeBop]

I think it was Walgreens that had to pay a great deal of money to a pharmacy technician as a 'whistleblower' since they had been giving giftcards to tricare members against federal law....Here it is:

http://www.justice.gov/opa/pr/2012/April/12-civ-505.html

So yes, Meijer will find themselves in trouble if they don't put an end to this.

Now I'm angry. They say that us government employees are government beneficiaries. Give me a break. We are employees of the government. We work for our wages; we work for our health care. Our coverage isn't just given to us. We work for it, the same as every other private sector employee. And our coverage and costs are compatible to the private sector. Oh, and we've gone without pay raises for the past two years.

Someone suggested to write to our congressional representatives. I live in Kentucky. One if our Senators, Rand Paul, introduced a bill that would combine Medicare with the Federal Employees Plan. So I don't think allowing us to get an extra 5% off of Disney Gift Cards by filling six prescriptions would grab his attention.

 

[ajh88]

We work for our wages; we work for our health care. Our coverage isn't just given to us. We work for it, the same as every other private sector employee.

I am just chiming in to say that many, many people on Medicare also worked for that benefit for many years and would scoff at being told that they are receiving government "entitlements."

I would suggest writing to the insurance commissioner of your state, or at least contacting their office. Even if they cannot change this law, they may be able to explain its origins better. And for the record, some states are excluded entirely (government, public, or otherwise) - Massachusetts comes to mind. The only reasoning I have come up with is that they exclude any insurance payor that is funded in whole or in part with tax revenue, which is what ends up lumping "entitlement" programs like Medicaid in with true insurance programs like Tricare.

 

[Swimalie]

Now I'm angry. They say that us government employees are government beneficiaries. Give me a break. We are employees of the government. We work for our wages; we work for our health care. Our coverage isn't just given to us. We work for it, the same as every other private sector employee. And our coverage and costs are compatible to the private sector. Oh, and we've gone without pay raises for the past two years.

So agree!!