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[IP] Advance PCS

I wondering if anyone else is having problems with Advance PCS with
their prescriptions? BC/BS on the East Coast changed over about 2
million customers from MerckMedco to Advance PCS in July. 

I have had three major problems with them. The first was right at the
switch over and they were telling me that my pump supplies were not
covered under my prescription plan even though they were covered under
Merck for the last several years. After 6 weeks of phone calls I got the
coverage again. It was a wrong code in the computer about what was and
wasn't covered.

The second was when I sent in a new prescription for the same pump
supplies because the old one ran out. My doctor has always put the NDC#
on the prescription and when it was received the wrong item was placed
in the computer and denied. This then two weeks to fix because they had
to pull the prescription to check the NDC#. I would think with the NDC#
on the prescription it would be doubled check from the start.

The third was over Labor Day weekend. I had mail ordered my humolog pens
and just received them. I also have a prescription at local pharmacy for
vials. When I'm out and at work I use the pens and home I keep a vial in
the frig and use that. Even though the pens and vials have different
NDC# and the same doctor is prescribing both it was kick back as denied
because it's the same drug. It took from Saturday to Monday to get an
override to have the vials covered. Once again never a problem with

I have talked to a supervisor at Advanced and I will have to get an
override every time I fill these prescriptions because it is for the
same drug. There is no way to place an over ride in the computer that
will stay. Now I know I can't be the only diabetic out of 2 million
people that uses both pens and vials of the same insulin.

Is anyone else experiencing trouble with advance PCS? What have you
done. Any suggestions on how to make a complaint? I have tried call our
benefit coordinator and called NJPlus (BC/BS) and gotten no where.

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