Thursday, May 11, 2017

Increased Co-Pay Increases Anger

It happens almost every day:

"Your total is $20 today, Mrs. Amountwatcher."

Mrs. Amountwatcher: "What do YOU mean, $20? It's ALWAYS been $15. YOU made a mistake. Get on the computer RIGHT NOW and fix it."

I fiddle on the computer to see what happened. It's been processed the same way it was last month. 

"We submitted the claim to your insurance, PAYNOW, just as always, and the claim came back this time for $20. Something might have changed with your insurance or formulary. Perhaps you received a letter in the mail about a co-pay increase for this medication. There's a lot of reasons why it might have gone up, but it's not because we made a mistake."

Mrs. Amountwatcher: "No, I did not get a letter. Nothing has changed. YOU made a mistake. I demand that you call them and find out what is going on."

Here we go again. If we are not currently busy, I will call the insurance for the patient and once they tell me the co-pay did indeed go up I will hand the phone to the patient so they can hear from the insurance that the co-pay has gone up. Other times I just tell the patient I will be happy to keep the medication in will-call until they "straighten it out" with their insurance. In that case they just come back a few days later and pay the new price.

This scenario has played out sooooo many times I can't keep track. For some reason people refuse to be the caretakers of their own insurance information. They refuse to open their mail or read the fine print on their insurance documents. They just assume we're trying out to "get them" at the pharmacy, and once they find out that yes, indeed, their co-pay has gone up and it has nothing to do with the pharmacy, do you think we get an apology? No.

Co-pays change. Prices increase. Policies change. Insurance changes. The entire system is dynamic. What's true today isn't always true tomorrow. STOP blaming your poor pharmacist or pharmacy technician when you get bad news at the pharmacy. We're doing the best we can to deliver your medication to you. We don't need a beating at the register.


Anonymous said...

Patients refusing to talk to their own insurance because they are too stuck up always amazed and pissed me off

tbunni said...

We in the doctors' offices get the same thing. 'What do you mean, my copay is $30.00? It has been $20.00 for five years!' Well, that might be why it finally went up. My favorite one though was a patient I was taking to on the phone asked what the copay was going to be on his new insurance. I advised him to check any literature he had gotten from his employer/HR. His response? 'Why? You guys set my copay don't you?' <<>>