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Thread: DH's frustration in trying to refill his meds

  1. #1
    Senior Member CathyA's Avatar
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    DH's frustration in trying to refill his meds

    DH went to the pharmacy to refill his meds. They told him that Medicare told our health insurance not to honor his prescriptions. They said he had refused to fill out some Medicare form. We haven't even gotten a form from them. Plus.......he's not even on Medicare. WTF?
    After spending about an hour and a half on the phone this morning (talking to the insurance company.....then being redirected to another department......which wasn't open, even though the first woman said it was). He called back to the original place and after talking quite awhile to a woman, they got disconnected. Finally, someone told him to call Medicare. DH is 64 and will soon need Medicare (as will I), but he's definitely not on Medicare now. The guy at the Medicare office said he definitely wasn't anywhere in their system. DH has to call back another one of their departments on Monday. The guy said it's a possibility is that there was some sort of fraud involved......but said that was remote.

    DH runs out of meds tomorrow. What a pain in the arse all this is. We're still trying to resolve another issue with our health insurance company. Someone at the previous company dropped the ball and didn't officially terminate our policy (even though we haven't paid for it in 4 months)....so our new insurance quit paying for things.

    This stuff could drive a person CRAZY!!

  2. #2
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    Since medicare uses a Social security number, it could be screwed up if someone did a typo with a similar number.

  3. #3
    rodeosweetheart
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    Oh, Cathy, HOW AWFUL. I am so sorry. It almost seems there exists a "No Healthcare" list like the "No Fly" list and somehow you are on it. It just seems you have gotten the bad end of the stick, healthcare speaking, of late.

    When I had my major hospitalization/health collapse/respiratory failure 10 years ago, it took me involving the state Attorney General's office to get the insurance to pay what they should have paid. I had 6 months of runaround, then got the AG involved, and presto, problem solved.

    I have no idea, in these awful days of ___ care, who you call.

    I am really sorry this is happening to you. If your husband's health is negatively impacted or threatened by not having the medication, then go to the ER and tell them that. They can get you meds.

  4. #4
    Simpler at Fifty
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    I would ask for a 5 day supply of the drug to get by until this is resolved. Pay cash. When it is resolved you will get reimbursed.

    This could be a fraud situation based on the issues with your accounts or charge cards that you have mentioned in the past.

  5. #5
    Senior Member Simplemind's Avatar
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    And I thought dealing with Comcast was bad...................................

  6. #6
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    CathyA: This is terrible! I hope you are able to get it resolved quickly. Meanwhile talk to your DH's doctor about the situation and see if they can arrange for some samples so he doesn't run out.

  7. #7
    Senior Member catherine's Avatar
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    I can totally commiserate, and I've had a horrible time getting DHs medications since transitioning from one plan to another (and both plans are within the SAME insurance company!!) We had to go to the doctor and get them to provide us with samples to get him through.

    My latest insurance "oh, no!" moment was just yesterday when I realized that because we had to re-enroll in the new plan September, we will wind up satisfying the deductible for this year (DH just had a procedure done), but the clock will be reset in JANUARY so we won't benefit from the post-deductible coverage (our new plan won't even cover medications until after the deductible is met). Arghhh….

    And the other "you gotta be kidding me" moment was just today, when I looked up to see if I have vision benefits. My glasses are horrible and I was thinking of going to an ophthalmologist for the first time just to get a good exam including glaucoma and cataract screening. Well, as it turn out, I do have a vision plan, but only that ridiculous pediatric vision plan that I was mandated to pay for. So, the $25 a month I pay does me NOTHING--and I get to pay 100% out of pocket for the eye exam and any glasses I get.

    It's almost laughable how ridiculous this all is… and NO I don't want to go back to the pre-Obama ways. I want to move forward and work out these gigantic kinks.
    "Do any human beings ever realize life while they live it--every, every minute?" Emily Webb, Our Town
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  8. #8
    Senior Member CathyA's Avatar
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    DH called the Medicare policy place, and no, he wasn't listed as being on Medicare.......so they fixed things and he got his meds. Is the foundation crumbling??
    Just this morning, I had to call my credit union, my cpap company and walmart, to try to work out mistakes they had all made. And that was just today. Last week I did the same thing with other companies.

  9. #9
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    I am so glad you got things straightened out!! We are on the Humana Medicare Gold Plan and they call DH every 3 months and ask if he wants his 2 inhalers refilled. Then they mail a 3 month supply. So far, it has worked very smoothly for us. When he qualifies for Medicare, you might want to look into the Humana choices.

  10. #10
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    Quote Originally Posted by CathyA View Post




    This stuff could drive a person CRAZY!!

    Yes, CathyA. it could definitely drive a person crazy! I've been pulling my hair out trying to schedule my surgery - between the doctor's office, the hospital, and our insurance there has been nothing but stupid screw-ups from people not doing their job correctly. It is very worrisome and who needs that when they're about to have a serious surgery!

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