RE: [IP] Medco
I have been told by Medco that the amount was over the limit. When I
challenged that and contacted my benefits admin they have changed the tune.
I have told them that I want a copy of what is the max allowed in writing
for all meds. They have refused. I have been told by my admin that the
contract does not state any limits but Medco sets them based on 'Good
Medical Practice'. When they try to override my Dr. I have informed them
that they are not licensed to practice medicine and they have always backed
down. I think that they feel if they deny something that most people don't
complain and therefore they can save money.
From: email @ redacted
[mailto:email @ redacted] On Behalf Of Lona Lassner
Sent: Wednesday, September 30, 2009 4:56 PM
To: email @ redacted
Subject: [IP] Medco
In response to the folks having issues with Medco . . .
(This is my personal experience only)
When your company contracts with Medco for pharmacy coverage, they have
contract limits as to how much of any particular medication they will
cover--no matter what your doc actually prescribes.
I have actually gotten letters from them in the past telling me that they
will only fill up to a certain # on some of my prescriptions--period. As I
have had chronic yeast infections
For the past several years--my doctor usually writes a prescription for as
many as 1 per week for a 3 month period. They decided they would only fill
up to the max that the contract
covered--which was significantly less than what my prescription was for. In
those situations, my doctor has been gracious enough to provide me an extra
prescription script that I can
pay cash for should I need to exceed what Medco would cover. It's not great
by any means--but it has worked for me. Luckily, this is a fairly
inexpensive medication--otherwise, I would
be in big trouble.
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