Mail order Prescriptions

[cheshireqt]

My insurance has harassed us for 2 years to switch from filling prescriptions locally to mail order. (They call at least once a week!) The savings were not there and I like to have some control so did not switch. Now all my families 90 day prescriptions have been knocked down to only 30 days and have to pay the refill 3 times instead of one time. So $75 for my non generic instead of $25, and $30 for DH generic instead of $10. Plus there is the hassle of having to get them filled every month, instead of every three months! I feel like I am being blackmailed into mail order prescriptions.
My questions are these:
1) do I have any recourse besides fussing at them to switch it back to 90-day. I assume they are within their "rights" to cause me discomfort forcing me to do something I don't want to do so that it is not just the company that reaps reap "the cost benefit." In other words assuming I will switch to mail order to save $60 for the 3 month time frame -or- $240 a year.
2) Has anyone switched to mail order and preferred it?
3) Do you have to remember to leave enough time to make the call and order or do they automatically send the refills? I usually realize when I get down to 2 or 3 pills but has never been a problem because can have it filled and back home within 20 minutes.
Any advice or stories are appreciated.

 

[mum4jenn]

When my Dh worked at Cooper Tire we had Medco as the mail in pharmacy. I believe you can request it to be an auto fill but I never used it. I really loved it because it was easy to check info on the website and it will show when you can re-order and you can look up the history as well as print up a year end tally for tax reasons. The meds come very quickly and there is an option for rush if you need it.

I was extremely happy with their service and would love to have that again one day.

 

[DisMN]

I feel your pain. We went through the exact same thing with our insurance and the kicker was that our good friends own our local pharmacy so we really really really didn't want to switch to mail order.

I hate....nay...I detest the mail order stuff for all the negative reasons you listed. Also the mail order is confusing (not my fault but the fault of their stupid, dumb, idiotic website...it's VERY unorganized). If you get something wrong it's very difficult to fix it with mail order. I liked going in and actually talking to someone to get the scoop on my meds, you know like contraindications and stuff. Mail order people are really only there to sell/send you their products...you won't get a one on one answer from them on anything.

Hate mail order but we're forced to have it.

DO love getting 3 months worth of meds but have found the prices higher via mail order. LOL A med I get locally would cost less than $2.00 but mail order it's $17.00. I mean what the heck????

Sorry for the rant but I get angry that we were forced to go mail order. LOL

 

[LuvOrlando]

I had trouble with Medco over this last year, please excuse my rant about it. It started with switching to mail order but morphed into very dangerous territory. FIrst it was about escalating costs because I liked having a Pharmasist instead of mail order even though Walmart charged me bout $20 cheaper per drug than mail order. Next they were charging us $70 a month for my DD's Flovent because it wasn't preferred. There is a huge legal issue here. Who gives them the right to define preferred or not preferred? If my kid's Dr says HE prefers Flovent because it is best for my kid then it is preferred by the only entity relevant. I think in these instances the Insurance companies are treading dangerously in the area of acting as Dr's. I thought only Dr's got to prescribe medical therapy? Who are the providers to offer a second opinion on medical care??? Personally, I paid out of pocket but I kept getting letters and phone calls from Medco about my choice. Can you believe as a follow up they even went so far as to send me a letter letting me know they had contacted my DH & child's Dr's to 'discuss with them' alternative drug therapies that were 'PREFERRED'? Holy cow did I hit the ceiling and screamed at everyone I could get my hands on that in no way were they allowed to act as an agent of any member of my family to get between my Dr's and us. I had to remind them that what goes on between our Dr's and us is confidential and privileged and that they had NO RIGHT to try and intervene. They had access to our medical info ONLY so they could process info, they had no right to use that data for other reasons. If INS wants to pay fine and if not it is my right to go somewhere else or pay out of pocket. NO-ONE was given the right to act on our behalf and no-one gave the Dr's office the right to reveal our confidential info. Both my DH's company and Medco were warned that I was keeping the letters and that if ANY of their employees ever cross the line again I was getting a lawyer and hitting the news.

This past year I did allow them to move a handful of medications to mail order, including the Flovent, because the terms changed and I was only being charged $70 for 90 days instead of per month like last year. My biggest gripe was worry over the medications being held in a hot warehouse somewhere in the summer heat and being destroyed during transit. So I insisted that they mail it with ice, which they did after a good deal of negotiating. If you do agree to let them mail your stuff I would also insist on the ice, medications are very delicate and can easily be destroyed.

I am very wary of these big drug providers. There is no way they do not know how the law views the rights between a citizen and a Dr. They are pushing because most people do not know their rights and are preying on the vulnerable. I'm afraid things may only get worse with the way the medical system seems to be moving. Once the bureaucrats get to be king makers we might not even have non-prefered choices to chose if all the competitors dry up due to lack of demand.

 

[DisneyAndRedSox]

I have Aetna mail order and love it. I get an email when I eligible to refill and get it in less than a week.

 

[Green Tea]

I had to use one that was from somewhere in Ohio. I hated them. They would do an auto call to say they got my prescription. (I know because I had called earlier and had to deal with phone tree hell to give it to you) Auto call to say they were filling it. Again when they were shipping it. I used them b/c 90 day were filled for 2 copays instead of 3. The insurance eliminated the discount for 90 days and I never used them again. I hated it.

If the insurance partners with one that allows thing to be done all online it wouldn't be much of a problem. We had a good one once.....so they changed it.

A lot of mine I now fill without running thru insurance at Kroger. I can get 90 days filled that way, and the low price list is less than what my insurance make me pay.

 

[DisMN]

I had trouble with Medco over this last year, please excuse my rant about it. .

You are forgiven....because my rant/vent was about Medco as well. LOL
What it seems to me is that we've moved from taking our tech companies overseas to our pharmacy *overseas* so to speak. Has anyone who has Medco tried to actually talk to them? Oh my lord in heaven.....


*disclaimer* By overseas I mean non local, not in our county not even in our own state.

 

[ajh88]

I don't like mail-order pharmacy out of principle - they are typically double-dippers, so to speak. Doesn't it seem odd that your prescription benefits are administered through Medco (or insert other pharmacy benefit manager name here), you pay your premium to Medco, and voila, Medco mail-order pharmacy wants you to buy your medication from them, so they get to collect your co-pay too! They may not all work this way, but it is fishy business, IMHO. I also don't like that they do what the OP has experienced in the form of forcing people to use them, whether they want to or not.

OP, my only (albeit not great) advice would be to let your employer (HR or benefits coordinator) know that you are unhappy about the way the insurance is being handled. They won't know unless you tell them. As for the numbers, I don't know - some people probably do save money but I don't think everyone does.

A side note to LuvOrlando - I completely understand your frustration and your anger, especially for a medication your child needs and I would be upset to think the insurance contacted the physician without my request or permission. However, the presence of a formulary (what they do or don't cover), isn't a legal problem, IMHO. They do try to get people to purchase medicine which is cheaper for them - such as a generic vs. a name brand - and they try to guide them in that direction, but they aren't making medical decisions since it is ultimately up to the physician to prescribe the medications they think best for the particular patient. I wish that every insurance would cover every medication, regardless of cost - but, that would be a great way for insurance companies to justify increasing premiums, possibly to a prohibitively high level. It stinks and I don't think it's going to get any better - I really despise insurance companies much of the time.

 

[The 4 "Quay"balleros]

My insurance company, starting about a year ago, made it mandatory to use Medco for any prescriptions that you are always on(sorry forgot their technical term) They allow you 3 refills at the pharmacy, but after that they WILL NOT cover the price(the only exemption is if it's a critically life threatening issue) So now we use Medco for my sons Singular. Actually it hasn't been bad, the only thing is that every couple of months we have to get new scripts.

 

[scdak]

I have used mail order for meds for about 7 years and love it, I have had 2 different companies due to change in management at work. The first company charged 2 months copay for 3 months of meds, I would get an email that it was time to refill the meds, a few clicks on the computer and I was done, they always arrived within a week even though I was told it would be 2-3 weeks, but they allowed the refill to be processed 2 months into the prescription, so even if it took that long, they were still here before I needed them. The current company is a little higher price but it has a max copay of $750 for the year then all meds are free for the rest of the year, by it by mail or if I have a single prescription filled at a local store, I reached that max in June. I even have meds that require refrigeration, from either company they are sent overnight delivery and packed with ice packs that are still solid when they get to my house. The only drawback that I found was if I had any pain meds that are controlled substances mailed I had to be here to sign for them, or they would allow my mother to sign for them but they could not be left without a signature, but that is no different from picking them up from a pharmacy.

I will admit that they do control what meds they will cover, and they will suggest that the doctor prescribe a lower priced alternative but the only medication that I could not have changed was finally paid for when my doctor sent documentation that it was necessary.

 

[peggster]

Warning, another rant ahead.

I have Aetna's mail order pharmacy, and I hate it. It used to be optional, but as of this year it's mandatory for most medications. My biggest frustration with it is the lack of control I have over the process. In the past, I knew how many pills I had left, and I could call in a refill if there were any left or have my doc write a new script, and either way I'd get the medication quickly. Now I have to plan ahead a month in advance to get a prescription filled.

I just went through a nightmare scenario with them last week. They've told us to allow 2 weeks from when we mail the prescription to when the pills arrive in the mailbox. I knew exactly how many pills I had left from my previous prescription, so I planned ahead and had my doctor write a new prescription for me. I mailed it off 2.5 weeks before I knew I would run out of pills. Well, the pills didn't come after 2 weeks. When I called to find out why (after going through phone tree hell to get a live person, and entering my ID number 3 different times), I was told I should have allowed a month between when I mailed the prescription and when the pills should arrive. (This was about 2 minutes after he originally told me to allow 2 weeks, until he realized it had already been 2 weeks; then his story changed.) I asked him what I should do if the order didn't arrive before I ran out of pills, and he said they would allow me to have my doctor write a new prescription for a 15-day supply to tide me over. The kicker is, I would have to pay out of pocket for that 15-day supply, at the retail price. The order did finally arrive several days later, but now I have to allow at least a month for the pills to get to me. I think that's crazy.

Oh, and one other thing that annoyed me: last year, before using the mail order pharmacy was mandatory, the copay for 3 months was the same as 2 months - sort of a buy 2, get 1 free deal. Now that we're required to use it, the difference between mail order and a retail pharmacy is a savings of about 15%.

Unfortunately, OP, I think you're stuck. We had no choice in the matter. If we don't like it, the only alternative is to pay out of pocket. Good luck!

 

[disfan07]

we have anthem BC/BS insurance. We HAVE to get our prescriptions through mail order or our insurance will not cover it. We get the initial prescription filled and than we get 2 refills after that. If we need another refill and it is not thorugh express scripts we pay full OOP.

For us it is cheaper to get the 90-day supply through mail order AND we dont have to remember to refill it (we get auto refill on our prescriptions) but I do prefer to be able to get my prescriptions on my own but it is what it is.

We now have copies of the forms that doctors have to fill out explaining why i need to more expensive prescription and eveyrtime I send in a new prescription my drs automaticlaly fill one of those out and send it in as well. I have 8 doctors. I dont have time to drop off/pick up forms from all of them, etc because our insurance companies suck and only care about money.

 

[tar heel]

If it's a maintenance med, we don't have any choice if we want insurance to cover it. That being said, it costs less than three co-pays (we've never been able to get 90 day scripts at pharmacies) and it's really easy once you get everything set up. You get your doctor to write the script for a year.

This is Aetna, and we've found new prescriptions that you mail in to one to two weeks and refills four or five days. We also had no trouble at all getting a walk-in prescription covered when the mailed in script did not arrive in time -- I told the pharmacist the situation when I gave her the script and she handled it.

We've also had Medco and didn't have any real problems with it, either.

 

[cheshireqt]

Thanks for the responses. It is Medco we will be dealing with. Glad to hear a few happy stories in there. In the past letting our company plan administrator know when we are not pleased with the insurance has not generated any kind of help whatsoever. She is just a very unhelpful person all the way around, unfortunately. I am peeved about being blackmailed into mail ordering, but I also harbor another suspicion...that they are going to switch over one of my medications to a generic. They have tried many ways to do so, from charging me a higher co-pay to outright denying it, until Dr calls and explains AGAIN why generic is not the recommended treatment for my condition. I am fearful that one day I will just receive the generic in the mail!
Thanks also for the advice on how long in advance to order. I was really hopeful that it would be streamlined and computerized, taking some of the burden off of my poor memory. As in, oh her medication is about to run out, time to send more. Then I would get a call telling me they are on the way. When the refills run out they would just call the Dr and get new refill prescription. Sounds like that was a fairytale dream though...sigh.

 

[Mom2Ben02]

We had a nightmare here, too. I sent in my script for 3 mos of prenatal vitamins. I was paying $7/mo at CVS for my co-pay. The prescription gave the OK for generic, and I always used it. Well, sent in the script - was supposed to be $14 for 3 mos. I got the meds - my co-pay was $100!! Turns out that they reformulated the medication, and there was no longer a generic version. If I had gone to CVS, I would have refused it. However, they mailed it and would not take it back, because it was not their fault. Luckily, I cried and they took pity on me, but I will NEVER again fill a prescription by mail.

 

[Kitzka]

We have been filling all scripts by mail for about 4 or 5 years. Both palms were through medco and we love it. It never takes more than 2 days for us to get our meeds (DH had a refill for his maintaince med called in on Thursday afternoon and we got the meeds sat am).

For us its cheaper and easier than going to the pharmacy. DD is on a maintience med and if we filled at the pharmacy it would be $10 a month but through medco its only $2.70 for three months.

Lara

 

[RNMOM]

Another member forced to use Medco here. I get really fed up with being "encouraged" to go generic or with a different medication. I have actually been sent letters encouraging me to switch to this new generic medication instead of the one I am on only to see it is not even the same medication. Really steams me getting things mailed to me when all these companies complain about all the costs of doing business. Stop mailing cr*p then. I feel the same about charities that do it.

I too had my doctor contacted about changing a medication. She actually then called me at home to discuss it. We agreed to give it a try and it worked so I am still on it but at the time I didn't even think about the HIPPA violation.

Do you all know each state has an Insurance Board? They handle complaints and make regulations so if you have a complaint, contact them. I wish I had thought about it last year when it happened to me.

I believe most of what we all don't like is due to the type of contract our employers make with Medco. We also have to use them for recurring meds. They won't pay after the 3rd Rx. This changes last year at the same time we renewed the insurance information. I bet Medco shows stats to prove how much they save the company and wham it is done.

One other thing I had happen several years ago was changing from Aetna insurance and Rx to Anthem and Medco Rx. Medco had all my medication information already. I know because of the copays. It had been an expensive year and we met our deductable. How is it that they can know that? Not legal in my opinion.

 

[Swimalie]

I use Medco, by my choice. Except for their web site being down occasionally, I haven't had any problems. I use a non-generic and haven't had any issues of them contacting me about using that brand drug. My insurance company has written me about the brand drug, but not Medco. Medco is not insurance, they may recommend a generic but I haven't heard them contacting anyone until reading here and almost all my friends locally use them.

Last week their web site was down so I called to order a refill and they said I would get it by the 9th (today). It arrived last Thurs. They are fast and very efficient.

 

[LuvOrlando]

I too had my doctor contacted about changing a medication. She actually then called me at home to discuss it. We agreed to give it a try and it worked so I am still on it but at the time I didn't even think about the HIPPA violation.

The reason HIPPA was on my mind is that someone very close to me had been working very closely with his company making sure it kept in step with HIPPA regulations. Did you know that these companies are REQUIRED BY LAW to strip our files of any and all identifying information before working with it in any way shape or form? The data is supposed to be passed through filter after filter to make everyone anonymous statistics. They are not allowed to connect the dots back to us, it's strictly prohibited. So if they are following the law and sanitizing our records how are they making their way back to this? Absolutely a flagrant abuse of our information in defiance of our laws. Even worse, I was contacted by Medco on numerous occasions to see if I wanted help managing my kids Asthma care. I listened to see what they had to say, it seemed as if they were trying to get between me and my kids' Dr by recommending care options and discuss the medications we use. This was a RN, not a Dr and not allowed to practice medicine the way it was being done, yet there she was acting like a Dr giving a second opinion. Again I flipped my lid because again, my rights are not being observed. IF our records are properly sanitized how would Medco know my kids are Asthmatic? These behaviors are blatantly illegal yet it's totally ignored. Where are our lawmakers on this? Shouldn't there be someone working on this? We're not talking a Mom & Pop place, Medco is enormous. Oh, that's right... other stuff is keeping them busy.

My body, my choice.

 

[ariel71]

The reason HIPPA was on my mind is that someone very close to me had been working very closely with his company making sure it kept in step with HIPPA regulations. Did you know that these companies are REQUIRED BY LAW to strip our files of any and all identifying information before working with it in any way shape or form? The data is supposed to be passed through filter after filter to make everyone anonymous statistics. They are not allowed to connect the dots back to us, it's strictly prohibited. So if they are following the law and sanitizing our records how are they making their way back to this? Absolutely a flagrant abuse of our information in defiance of our laws. Even worse, I was contacted by Medco on numerous occasions to see if I wanted help managing my kids Asthma care. I listened to see what they had to say, it seemed as if they were trying to get between me and my kids' Dr by recommending care options and discuss the medications we use. This was a RN, not a Dr and not allowed to practice medicine the way it was being done, yet there she was acting like a Dr giving a second opinion. Again I flipped my lid because again, my rights are not being observed. IF our records are properly sanitized how would Medco know my kids are Asthmatic? These behaviors are blatantly illegal yet it's totally ignored. Where are our lawmakers on this? Shouldn't there be someone working on this? We're not talking a Mom & Pop place, Medco is enormous. Oh, that's right... other stuff is keeping them busy.

My body, my choice.

Lots of misinformation by this poster about HIPAA (not HIPPA). I would recommend reading the law - the above scenario is an entirely permissable use of Protected Health Information.