It never fails…we show up to pick up prescriptions for Liam and we’re hit with huge bills. This time, the bill was almost $600. It’s always because they have billed things incorrectly and listed things as requiring co-pays when they should not be.
So, we usually have to spend 3 or 4 hours on the phone every 90 days with our Insurance and CVS (corporate), who has to work with our local CVS to figure things out.
The way our Insurance works is as follows:
We “bundle” all diabetes supply on a single prescription for 90-days (the 90-day part is required). We have written into our prescription the following items: Test strips, glucose tabs, alcohol wipes, glucogon, lancets, syringes, insulin (both vials and the pens…the vials is carried over from a previous prescription that hasn’t expired yet, and the pens is the “new” method we are using so we are getting Lantus and Novolog pen cartridges as well as the applicable pens for these insulins.)
With our bundle agreement with our Insurance, we’re required to pay for the most expensive item, then everything in the bundle is free. In our case, the Insulin is the most expensive part. So everything else should have been free…but inevitably, each 90-days, they attempt to charge us more than they should by applying co-pays to items that they shouldn’t be applying co-pay charges for.
So after 3 - 4 hours on the phone with various departments to get things figured out.
The beginning “cost” for the day was $565. After spending the 3 hours on the phone, it went down to $189. After utilizing the Novolog “discount card” we will spend about $100 out of pocket. That’s not bad at all for a 90-day supply of Insulin supplies (this doesn’t include the sensors/transmitters…different company and full cost will be required for these until we meet our annual family out-of-pocket requirement.)
Anyway, so they did “manual overrides” for us on the phone to fix things…but I just wish they would FIX IT so that next time we come to get our prescriptions filled, we don’t have to spend hours on the phone with them getting it worked out.
Anyone else use CVS and has had similar issues of them never getting things written up/submitted correctly to insurance?