Lawana Posted February 7, 2012 Share Posted February 7, 2012 Our health insurance requires us to use Express-scripts mail order pharmacy for maintenance drugs─otherwise no coverage. Since dd's insulin and test strips would cost several hundred dollars per month if we had to pay out of pocket, we feel compelled to use the above mentioned company. I recently mailed in two prescriptions. Checking the online status, I see that one of the prescriptions has been entered into the system, but not the other. Having had previous experience with holdups for various reasons, I call customer service. Who informs me that they cannot "see" new orders for 48 hours after they have been entered. So let me get this right─I, as a customer, can see the info for a new order, while they, as part of the company, cannot! So I have to wait until tomorrow to call again, because they won't do anything until it's been more than 48 hrs. All I want to know is if there is a problem with the other script. Because based on previous experience, it could be held up indefinitely, with no communication from them. :banghead::banghead::cursing::cursing::banghead: :rant: Quote Link to comment Share on other sites More sharing options...
Tap Posted February 7, 2012 Share Posted February 7, 2012 I work in retail pharmacy. We hear complaints about mail order ALL. THE. TIME. When it works...it is great. When it doesn't work....it is horrible. The one time I tried to use mail order was for a medication that was hard to find at the time. I contacted mail order and they couldn't tell me if they had it or not, so I decided to take a chance and try anyways. A MONTH later, I hadn't heard anything from the mail order company, so I called. They could see I had an account and that each member of my family was registered and everything was in place to fill prescriptions, but they had no record of the script arriving. All of my registration information was sent with the script, so if they got the registration information...they got the script. Shortly after that, I got a letter in the mail. Addressed to me, with all of my contact information on it, including my account number. Attached was the prescription. The letter, said they couldn't fill the prescription because they couldn't match the person/account number........:banghead: Hmmmm, then how did they know who to send it back to, and how did they attach the correct account information to it? I hear stories like this all the time. They make no sense. Sorry you are having to go through this. It really is frustrating. Quote Link to comment Share on other sites More sharing options...
Lawana Posted February 7, 2012 Author Share Posted February 7, 2012 Thank you. I truly wish we had an option. I'd pay a higher copay to go through a retail pharmacy, but we have no choice. We're stuck with dealing with them or paying several hundred a month out of pocket. Quote Link to comment Share on other sites More sharing options...
ZooRho Posted February 7, 2012 Share Posted February 7, 2012 I know we have the same mail order. it can be insanity. and now we can't use Walgreens GREAT. Quote Link to comment Share on other sites More sharing options...
Murphy101 Posted February 7, 2012 Share Posted February 7, 2012 I know we have the same mail order. it can be insanity. and now we can't use Walgreens GREAT. Us to. It's either fine or it's a nightmare expensive PITA.:glare: Quote Link to comment Share on other sites More sharing options...
Geo Posted February 7, 2012 Share Posted February 7, 2012 My poor husband is a frequent victim of the Express-scripts fiasco. :glare: Quote Link to comment Share on other sites More sharing options...
Candid Posted February 7, 2012 Share Posted February 7, 2012 Is it possible you might not need to use Express Scripts? I ask because over the summer we got a notice that indicated our drug benefit would no longer pay for my dh's many prescriptions locally and we had to use Express Scripts. He checked with his business and found out this was not true. I don't know if it was incorrect mailing to folks at his business or if it is routine for them to send this out to folks they are available to. So if you haven't asked the HR folks at whoever provides the insurance, you might want to double check with them that you can't get things locally. Quote Link to comment Share on other sites More sharing options...
MariannNOVA Posted February 7, 2012 Share Posted February 7, 2012 I am so sorry that you must use them. I had an incident with them a couple of years ago with the kids' adhd meds. One of the twins' meds 'disappeared' prior to delivery bu after leaving their facility. Too bad, so sad for me!:banghead: The other twin's meds arrived and I didn't even open the plastic bag it was shipped in -- it had clearly been crushed by a tire going over it, or it had been smashed -- dh brought it to the Benefits Dept and had them open it -- it was shards and powder. i despise them. :grouphug: Quote Link to comment Share on other sites More sharing options...
Lawana Posted February 7, 2012 Author Share Posted February 7, 2012 Thanks. Yes, we actually do have to use Express-scripts, unless we want to pay full retail out-of-pocket. I'm also really bummed Walgreens is no longer in the network. Our neighbor is the general manager at the local Walgreens, and we always got issues resolved promptly.:001_smile: Quote Link to comment Share on other sites More sharing options...
grace'smom Posted February 7, 2012 Share Posted February 7, 2012 Is it possible you might not need to use Express Scripts? I ask because over the summer we got a notice that indicated our drug benefit would no longer pay for my dh's many prescriptions locally and we had to use Express Scripts. He checked with his business and found out this was not true. I don't know if it was incorrect mailing to folks at his business or if it is routine for them to send this out to folks they are available to. So if you haven't asked the HR folks at whoever provides the insurance, you might want to double check with them that you can't get things locally. We had this same sort of thing happen to us. You might want to check with the pharmacy that you usually use and see if they know a way around it. We were able to get around it but I don't remember how we did it. I know we had to contact our pharmacy and our doctor for assistance... Quote Link to comment Share on other sites More sharing options...
KidsHappen Posted February 7, 2012 Share Posted February 7, 2012 I have had so many problems with mail-in prescriptions over the years. So many! This year we found out that our in house prescription company would be CVS and that if we had a local store we could use that. The very first prescription I took in was a 90 day prescription. They took one look at it and said, "Don't have it. Haven't had it in 6 months. Ain't going to have it. You can try mailing it." Then I bring in 3 of my 90 day prescriptions. They filled one as written, 30 days of one even though the prescription was written for 90 days and the final one as some fraction there of without explaining any of it. I asked about the fraction and they gave me some explanation of why they did it the way they did but they didn't really explain why they didn't just fill it as they should have. I didn't even ask about the middle one because I didn't notice it until about a week later at home and if I hadn't had the experience with the previous fractional fill I wouldn't have even had any idea what was going on. For example, the last prescription was for 3 pills per day for 90 day or 270 pills, no refills. They gave me 90 pills and wrote one refill on the bottle. That doesn't equal 270 pills but I know from the previous experience that they keep track of the amount of pills you are supposed to have and just keep giving you refills until you get your total amount. The other prescription was a 90 day prescription of 180 pills with one refill. They gave me a bottle with 120 pills and one refill listed. There was no note or explanation on it and if I didn't ask or keep track of my meds I would have had no idea that I wasn't getting the right amount. I don't know if we have a set co-pay or a proportional one but it is a real pain in the ass because now I have to go about once a week to get prescriptions which totally defeats the purpose of a 90 day prescription. There are simply too many layers between a person and their prescriptions. It should be that a dr. writes you a prescription for what you need and the pharmacy fills it. Period. Full stop. But no, first there are certain laws that apply (some really arcane ones that only apply on the second Tuesday of the month if you happen to be wearing a purple and orange shirt) and then there is your insurance that has to approve your prescriptions. Sometimes by the time you get your prescriptions you can not take them as prescribed. I have taken to using an out of state mail in pharmacy that I pay for myself for the prescriptions I have difficulty filling. :glare: Quote Link to comment Share on other sites More sharing options...
Lawana Posted February 7, 2012 Author Share Posted February 7, 2012 We had this same sort of thing happen to us. You might want to check with the pharmacy that you usually use and see if they know a way around it. We were able to get around it but I don't remember how we did it. I know we had to contact our pharmacy and our doctor for assistance... Believe me' date=' we've tried. No go.:glare: I have had so many problems with mail-in prescriptions over the years. So many! This year we found out that our in house prescription company would be CVS and that if we had a local store we could use that. The very first prescription I took in was a 90 day prescription. They took one look at it and said, "Don't have it. Haven't had it in 6 months. Ain't going to have it. You can try mailing it." Then I bring in 3 of my 90 day prescriptions. They filled one as written, 30 days of one even though the prescription was written for 90 days and the final one as some fraction there of without explaining any of it. I asked about the fraction and they gave me some explanation of why they did it the way they did but they didn't really explain why they didn't just fill it as they should have. I didn't even ask about the middle one because I didn't notice it until about a week later at home and if I hadn't had the experience with the previous fractional fill I wouldn't have even had any idea what was going on. For example, the last prescription was for 3 pills per day for 90 day or 270 pills, no refills. They gave me 90 pills and wrote one refill on the bottle. That doesn't equal 270 pills but I know from the previous experience that they keep track of the amount of pills you are supposed to have and just keep giving you refills until you get your total amount. The other prescription was a 90 day prescription of 180 pills with one refill. They gave me a bottle with 120 pills and one refill listed. There was no note or explanation on it and if I didn't ask or keep track of my meds I would have had no idea that I wasn't getting the right amount. I don't know if we have a set co-pay or a proportional one but it is a real pain in the ass because now I have to go about once a week to get prescriptions which totally defeats the purpose of a 90 day prescription. There are simply too many layers between a person and their prescriptions. It should be that a dr. writes you a prescription for what you need and the pharmacy fills it. Period. Full stop. But no, first there are certain laws that apply (some really arcane ones that only apply on the second Tuesday of the month if you happen to be wearing a purple and orange shirt) and then there is your insurance that has to approve your prescriptions. Sometimes by the time you get your prescriptions you can not take them as prescribed. I have taken to using an out of state mail in pharmacy that I pay for myself for the prescriptions I have difficulty filling. :glare: :iagree::iagree::iagree: One of the issues I had was E-S filling a prescription for a namebrand med with a generic, after I had told one of their reps I wanted the namebrand. They wanted me to get the doctor to reissue the script. Nope. Not going to happen. They tried to tell me the law required it. So I looked up the law in the state the pharmacy was in. It was only after I read the law to the pharmacy manager that somehow they were then able to reissue the namebrand. Of course this only took several phone calls, and an hour of research.:banghead::banghead: Quote Link to comment Share on other sites More sharing options...
itsheresomewhere Posted February 7, 2012 Share Posted February 7, 2012 Is it possible you might not need to use Express Scripts? I ask because over the summer we got a notice that indicated our drug benefit would no longer pay for my dh's many prescriptions locally and we had to use Express Scripts. He checked with his business and found out this was not true. I don't know if it was incorrect mailing to folks at his business or if it is routine for them to send this out to folks they are available to. So if you haven't asked the HR folks at whoever provides the insurance, you might want to double check with them that you can't get things locally. :iagree: We have express scripts and are not required to use them no matter what express says. I also have been price checking stores and use Target, Wegmans and Walmart. One med from Express is 45 for a 90 day supply or 10 bucks for 30 from Target without insurance. Quote Link to comment Share on other sites More sharing options...
ZooRho Posted February 7, 2012 Share Posted February 7, 2012 Thanks. Yes, we actually do have to use Express-scripts, unless we want to pay full retail out-of-pocket. I'm also really bummed Walgreens is no longer in the network. Our neighbor is the general manager at the local Walgreens, and we always got issues resolved promptly.:001_smile: did you complain? I did sign something at Walgreens I probably should have complained more though. I had to take an antibiotic to Walmart the other day YIKES what a NIGHT MARE. We have to find some where else to take it. Quote Link to comment Share on other sites More sharing options...
itsheresomewhere Posted February 7, 2012 Share Posted February 7, 2012 did you complain? I did sign something at Walgreens I probably should have complained more though. I had to take an antibiotic to Walmart the other day YIKES what a NIGHT MARE. We have to find some where else to take it. Target does the free ones. Quote Link to comment Share on other sites More sharing options...
SweetMissMagnolia Posted February 7, 2012 Share Posted February 7, 2012 yeah know what you mean-I have to get my test strips that way too and it's such a hassle sometimes.... Quote Link to comment Share on other sites More sharing options...
ZooRho Posted February 7, 2012 Share Posted February 7, 2012 Target does the free ones. what do you mean they do the free ones. I hate going to the Target closest to us it is not a convenient thing to get into. It would be nicer than Wally world though. Walgreens was just closer and easier to get into. Quote Link to comment Share on other sites More sharing options...
itsheresomewhere Posted February 7, 2012 Share Posted February 7, 2012 what do you mean they do the free ones. I hate going to the Target closest to us it is not a convenient thing to get into. It would be nicer than Wally world though. Walgreens was just closer and easier to get into. Target has a nice list of antibiotics that are free. I use them over Walmart. Quote Link to comment Share on other sites More sharing options...
ZooRho Posted February 7, 2012 Share Posted February 7, 2012 Target has a nice list of antibiotics that are free. I use them over Walmart. ah interesting. they are free with the Express Scripts? Quote Link to comment Share on other sites More sharing options...
itsheresomewhere Posted February 7, 2012 Share Posted February 7, 2012 ah interesting. they are free with the Express Scripts? Free without using insurance to anyone. It is for certain ones. Quote Link to comment Share on other sites More sharing options...
ZooRho Posted February 7, 2012 Share Posted February 7, 2012 do they have the list online? Quote Link to comment Share on other sites More sharing options...
Sebastian (a lady) Posted February 7, 2012 Share Posted February 7, 2012 Our health insurance requires us to use Express-scripts mail order pharmacy for maintenance drugs─otherwise no coverage. Since dd's insulin and test strips would cost several hundred dollars per month if we had to pay out of pocket, we feel compelled to use the above mentioned company. I recently mailed in two prescriptions. Checking the online status, I see that one of the prescriptions has been entered into the system, but not the other. Having had previous experience with holdups for various reasons, I call customer service. Who informs me that they cannot "see" new orders for 48 hours after they have been entered. So let me get this right─I, as a customer, can see the info for a new order, while they, as part of the company, cannot! So I have to wait until tomorrow to call again, because they won't do anything until it's been more than 48 hrs. All I want to know is if there is a problem with the other script. Because based on previous experience, it could be held up indefinitely, with no communication from them. :banghead::banghead::cursing::cursing::banghead: :rant: If I understand the Express Scripts thing correctly, they are a company with which insurance providers contract to provide prescription services. So would it be worth reporting each problem back to the actual provider? I'm not sure if there is a potential downside here (like having insurance dropped for some reason). But it might be worth letting a provider know that you're not satisfied or that ES is problematic. Quote Link to comment Share on other sites More sharing options...
itsheresomewhere Posted February 7, 2012 Share Posted February 7, 2012 do they have the list online? I got the paper from the pharmacy. Also, Wegmans does the same thing. Here is the Wegmans list. I know the Target one had just a few differences. http://www.wegmans.com/pdf/pharmacy/pharmacyGenericPriceList.pdf Quote Link to comment Share on other sites More sharing options...
itsheresomewhere Posted February 7, 2012 Share Posted February 7, 2012 If I understand the Express Scripts thing correctly, they are a company with which insurance providers contract to provide prescription services. So would it be worth reporting each problem back to the actual provider? I'm not sure if there is a potential downside here (like having insurance dropped for some reason). But it might be worth letting a provider know that you're not satisfied or that ES is problematic. They don't hear you. I know this had been a problem for years with them. Quote Link to comment Share on other sites More sharing options...
WeeBeaks Posted February 7, 2012 Share Posted February 7, 2012 I feel for you. We are required to use them as well. It is an incredible pain. Last time our doc was changing the dose of DSs meds every month to adjust it, and they still denied it and said we had to use mail order for a prescription changing every month. What a disaster. We are constantly running out and paying out of pocket due to holdups on mail order. It is a horrifying experience. If we didn't pay out of pocket half the time DS would be without meds periodically. Quote Link to comment Share on other sites More sharing options...
ZooRho Posted February 8, 2012 Share Posted February 8, 2012 I got the paper from the pharmacy. Also, Wegmans does the same thing. Here is the Wegmans list. I know the Target one had just a few differences. http://www.wegmans.com/pdf/pharmacy/pharmacyGenericPriceList.pdf Thanks Wegman's is cool too bad it is too far away. I'll ask for the list next time I go in there. Quote Link to comment Share on other sites More sharing options...
asta Posted February 8, 2012 Share Posted February 8, 2012 Thanks. Yes, we actually do have to use Express-scripts, unless we want to pay full retail out-of-pocket. I'm also really bummed Walgreens is no longer in the network. Our neighbor is the general manager at the local Walgreens, and we always got issues resolved promptly.:001_smile: Talk to your benefits manager. For life and death medications (diabetes) there are exceptions in ExpressScripts. I was allowed "out" because I can't be without my anticonvulsants even for a day, so if something in their system gets screwed up, or it gets lost in the mail, I would be screwed. Check on it. A Quote Link to comment Share on other sites More sharing options...
Sebastian (a lady) Posted February 8, 2012 Share Posted February 8, 2012 They don't hear you. I know this had been a problem for years with them. The only thing I was considering was that if enough people complained, perhaps the insurer would put pressure on their subcontractor. Especially if there is a possibility that the customer could pick a different insurance program instead (though that's probably not the case outside of things like government employees). It might give them grounds to renegotiate their contract with ES. For example, if the insurer is being charged for more DR office visits to get "new" scripts that are demanded by ES. I don't use them, since we have a military pharmacy nearby. But I'm irked by the idea that OUR coverage benefits are not irrevokably linked with the compensation contracts of a bunch of unrelated entities. My understanding of the ES vs Walgreens dispute is that Walgreens offered better rates on the military Tricare clients, but not for ES clients covered under other programs. ES took away all of their customers rather than negotiate different payment rates. That bothers me, because it means that my health access is being determined by a subcontractor that has their own bottom line at heart, not by me and not by my insurance provider. Quote Link to comment Share on other sites More sharing options...
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