But your medication is important! The doctor prescribed it for you to treat a condition to keep you alive or make you better! So here are the TOP TEN secrets to getting better pharmacy service!
10. You wouldn't believe this, but this one is simple: Have your ID and prescription insurance information WITH YOU when you go to the pharmacy counter. Our system works differently than dental plans. We NEED your prescription insurance information to process a claim. We have no way to "look it up" on the computer. Having your information reduces a lot of time in the process.
9. Be wary when your doctor says she's going to prescribe something "new on the market" for your condition. New usually means EXPEN$IVE and that usually means it is NOT on your FORMULARY and therefore not covered on your insurance. The drug representatives that told the doctor about this new medication most likely told the doctor the insurance plans that cover the new medication and it most likely went right out of her head. Ask the doctor to check if it is covered. If you get to the pharmacy and we find out it isn't covered, we're going to spend a lot of time trying to take care of this for you (such as a PRIOR AUTHORIZATION). Even if it is covered it is probably expensive and we won't have it in stock. These are issues to discuss with the doctor BEFORE you leave her office.
8. Some new drugs come with a manufacturer coupon to reduce your co-pay at the pharmacy. If your doctor gives you one, take a quick peek to see if it has an expiration date on it. They usually do and doctors hand them out like candy not even noticing if they're expired. Also take note... if you're on an federal or state-funded insurance (Medicare or Medicaid), you can't use the coupon. It's federal law. I don't make the rules. Lastly, these coupons often require "activation" ~ you call a number and give them personal information then they make the ID number on the coupon active. Too many people bring in coupons that are not activated and it slows down the entire filling process and YOU will have to wait.
5. Picking up medication for someone else, like a family member? Ask them the name of the item. What we have on the shelf waiting for you and what you're expecting might be different. Once it leaves the pharmacy, it is not coming back, so be sure BEFORE you pay for it.
3. It's tempting to switch pharmacies when gift cards are offered for transfers. The Authorities want your business and they'll pay money to get you to our pharmacy. But as an overseer of your medication therapy, I have to tell you that you're a lot better off choosing ONE pharmacy and staying with that ONE pharmacy whether it is us or not. When the pharmacist knows your complete history and all the medications you take, we are able to make optimum decisions about drug interactions and your therapy. Pharmacy service tailored to YOUR needs is worth a lot more than a $25 gift card.
2. The time to discuss your co-pay is when you drop off your prescription, NOT at the register. We don't have anything to do with the co-pay -- that amount is given to us from your insurance. Asking us to do any kind of checking or researching at the register slows the entire process down for everyone involved, including you. If you don't think the co-pay is correct, step out of line and call your insurance to verify it and let us help the next person in line.
A side note for those manufacturers coupons... quite often they have a maximum amount the coupon will cover, so just because it says it "pay no more than $25*" for a $400 medication, if you follow the asterisk you'll read in fine print that it only covers "up to a maximum benefit of $100", leaving you to fork over the remaining $300.
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DeleteI work in HR and handle the health insurance plan. Our prescription coverage is very simple, employees pay 20% of the cost of the drug at the pharmacy (we also have a mail order plan with 3 copay tiers). Some of our employees can not grasp the fact that sometimes the cost of a drug changes, and call or email me to complain that their prescription cost them X number of dollars more than it did last month, and that means that clearly something was wrong with their insurance and they want me to call the insurance company to complain on their behalf. Even the president of our company pulled that one on me. A 10 second Google turned up info on the price of the drug increasing. I hate to think how they may have behaved at the pharmacy when they found out they had to pay a few dollars more.
ReplyDeleteI want to print this out and hang it in every exam room at the doctor's office where I work.
ReplyDeleteAlso, your patients need to thank their lucky stars that they don't need to go to a specialty pharmacy for fertility meds. That is a special layer of hell.
What is your thought on GoodRx coupons? Looks like they rarely work? We often have patients with no insurance.
ReplyDeleteLittle late to the party! I had a gap in insurance after my SSDI was approved. GoodRx saved me quite a bit ($50 to $150 below cash discount already offered) on some meds. About 50% of the time the GoodRx coupon would be right around the same price as what my pharmacist would have charged. One thing that definitely helped though was Patient Assistance programs. At one point, I was receiving my Plaqunal, Potassium Citrate, Restasis, Librax and more for free. Some of the applications were as easy as having your doctor sign and fax.
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