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[IP] 200 strips
Long, boring, unless you'd like to read how I waste my time :-)
The Blue Shield limit of 200 / mo is now history for Lily. I was a
pain to deal with. It seems that they don't care whether or not there
is a doctors written order or a prescription.
The whole story:
I started with a prescription for 700 strips = 60 day supply. The
mail order pharmacy takes about 3 weeks to fill an order even though
they claim 7-10 days -- right!
I took the prescription to the local Walgreens and their computer
kicked it out indicating that the maximum they could dispense was 200
for a 30 days supply rather than the 350 I was seeking.
Called BS at 9:15, they insisted they insisted that the 200 limit
was hard and fast, in spite of the insurance contract language which
mentions no limits and state law which requires that they cover all
diabetes supplies. sigh....... finally I got someone to talked to
pharmacy services and while I got the same story, they did say that
the physician could override the policy if the called and/or filled
out some forms.
Called the docs office -- out of town, staff not in.
Called the clinic advice nurse, she said that Lily's PCP could
override the insurance company (at least the stories are consistent)
and to try the PCP. She said if there was difficulty, she would find
some doc at the clinic that could do it for us.
Called Lily's PCP (very nice by the way :-). Dr. Harvey said she'd do
what ever was necessary to make it work, just fax her the details,
which I did a few minutes later.
Within a half hour, Dr. Faxed me a copy of the letter sent to BS
pharmacy services. I waited until afternoon to give them time to
get there act together and then called to verify that the override
was in place NOT! After considerable hassle, extracted the number for
pharmacy relations from them and called Dr. Harvey's office yet again
and asked that they call and try to fix the problem. They were very
nice and said they'd do it asap.
Monday morning! Called BS to verify that the override was in place.
This was pretty much a repeat of Friday's frustrations, but after
about 10 minutes the customer service rep gave up and gave me the
(wrong number) of the pharmcy service group. I called them and was
informed that while they handled BS pharmacy stuff, that there was
another group that I really need to talk to to straighten out the
Called group #2 and talked to "Ben". Ben listened, looked up the
records, mumbled at me a little and then said "I put a permanent
override in place, you shouldn't have any more problems"
sure heh... heh....
With that conversation in mind, on my way home to make a sandwich for
lunch, I stopped off at Walgreens and gave it another shot.
No luck :-( The computer kicked it out. I explained my telephonic
travels to the nice lady at the pharmacy and SHE called BS pharmacy
services. Lo and behold, they DID have a record that there should be
an override and withing about 5 minutes I was out of there with 350
strips paid for with a $25 co-pay. The pharmacy lady asked how long
the override was good for and was told INDEFINETLY!
Well at least something finally went right!
Insurance companies are such fun (NOT)!
The moral of the story.... don't give up, don't take NO for an
answer. Even though they meant well, the pharmacy tried to get me to
take the 200 strips. I knew if I did that I was a dead duck.
email @ redacted
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