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HAPPY UPDATE.can someone talk me off the cliff? insurance people, asthma people, pharmacy people

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Janice
Sweet Jessie Quinn

Member since 5/05

27567 total posts

Name:
Janice

HAPPY UPDATE.can someone talk me off the cliff? insurance people, asthma people, pharmacy people

I refill Josh's pulimort this weekend.

Went last night to pick it up.

Pharm says insurance was terminated.
I did not worry too much, insurance was already closed for day, but Leo has same job so I know it must be a mistake.

I say okay, I have 2 days left of meds...

Call insurance this AM...they said he is active. I explain, girl says she will call pharm.

I wait an hour...another insurance person answers, says girl will call me back.

go to the park, come home, no calls.

call pharm...he says girl has called twice, they can't figure out why its not going through. He says they have gone through everything twice and nothing is getting approved, showing terminated.

I need this med by friday morning.

If it doesn't go through, its 400.00 out of pocket. The duo neb is more.

what's going on? please help. anyone???

tia

Message edited 11/12/2008 4:40:10 PM.

Posted 11/12/08 1:59 PM
 
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My4GirlsMyLife
My 4 girlies

Member since 2/08

9702 total posts

Name:
Valerie

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

Wow do you have HIP? B/c I recently went through alot of crapp with them Chat Icon They said DD #2 was terminated then #1 was fine then they terminated her too but I sent them the paymentsChat Icon DD31 also has asthma but thank god I have enough Albuterol for her!! Call the insurance company and demand to talk to a supervisorChat Icon

Posted 11/12/08 2:06 PM
 

beachgirl
LIF Adult

Member since 7/05

7967 total posts

Name:
sara

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

I would call back both the insurance co and the pharmacy and insist on speaking to a supervisor and dont get off the phone until you get answers.

Good luckChat Icon

Posted 11/12/08 2:08 PM
 

Janice
Sweet Jessie Quinn

Member since 5/05

27567 total posts

Name:
Janice

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

thanks, no BCBS.

I am SICK. I am going to give them another hour, then call.

I don't want to be stuck in a bad place tomorrow with his last doseChat Icon

Posted 11/12/08 2:09 PM
 

My4GirlsMyLife
My 4 girlies

Member since 2/08

9702 total posts

Name:
Valerie

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

Posted by Janice

thanks, no BCBS.

I am SICK. I am going to give them another hour, then call.

I don't want to be stuck in a bad place tomorrow with his last doseChat Icon



Do you have a nebulizer just in case? and maybe your docs office would have a sample? My daughter was on Symbocort and they had samples at the office

Posted 11/12/08 2:15 PM
 

Janice
Sweet Jessie Quinn

Member since 5/05

27567 total posts

Name:
Janice

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

I called and left message for allergist.

I just hope they believe me about all this...that i do have insurance and I am not trying to score free meds.

I will call his ped too.

thanks valerie!

ETA: I do have albuterol and duo neb just incaseChat Icon

Message edited 11/12/2008 2:19:50 PM.

Posted 11/12/08 2:19 PM
 

KateDevine
*

Member since 6/06

24950 total posts

Name:

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

1. Call the doctor and get samples.

2. If you HAVE to, pay the $400 out of pocket and once the mess up is straighted out, you should get back all but your co-pay. We had this issue last year with Christopher not being added properly to DH' prescription plan, I paid $100 for antibiotics and got back $95 a few days later.

3. Keep calling the insurance company until you get a person you can work with, get their full name, extension and keep (nicely) harassing them!

I'm sorry you have to go through this, but it will be worked out, just YOU breatheChat Icon Chat Icon Chat Icon

Posted 11/12/08 2:19 PM
 

My4GirlsMyLife
My 4 girlies

Member since 2/08

9702 total posts

Name:
Valerie

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

Posted by Janice

I called and left message for allergist.

I just hope they believe me about all this...that i do have insurance and I am not trying to score free meds.

I will call his ped too.

thanks valerie!

ETA: I do have albuterol and duo neb just incaseChat Icon



your welcome!! I just hope everything works out !! Keep me updatedChat Icon

Posted 11/12/08 2:20 PM
 

DRMom
Two in Blue

Member since 5/05

20223 total posts

Name:
Melissa

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

get on the phone with BCBS and tell them you will be complaining to the state dept of insurance if this is not handled immediately. hav ethem call the pharm with you on the line(have the number handy and the name of the girl at the pharm)

Posted 11/12/08 2:24 PM
 

doublestroller
LIF Adult

Member since 7/08

1179 total posts

Name:

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

BTDT recently...

got a crazy bill from a dr., called the office, they said i don't have coverage. called insurance company, they said it was a "computer glitch" and that i am in fact covered. insurance company said they would resubmit the paperwork, but it took a few weeks...

if i were you i would go to the pharmacy, call your insurance company and have the 2 directly talk to each other. there must be some type of confirmation/workaround that can be done given the urgency. i would also call the dr. for samples as a backup if need be.

hope you get it resolved asap!

Posted 11/12/08 2:37 PM
 

Janice
Sweet Jessie Quinn

Member since 5/05

27567 total posts

Name:
Janice

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

okay, thanks!

I called again...put on hold forever.

The girl from this morning picked up.

She said just as my med approval was going through, their system went into an update, kicking Josh out.

When josh was added back on, the dependent code was keyed wrong...

so, she said everything should be fine at pick up tonight.

I can breathe again.

Posted 11/12/08 3:24 PM
 

nrcsr
LIF Infant

Member since 5/05

186 total posts

Name:
Nenette

Re: can someone talk me off the cliff? insurance people, asthma people, pharmacy people

.

Message edited 11/12/2008 4:18:04 PM.

Posted 11/12/08 4:17 PM
 
 

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