The Pharmacy Chick

Flying the coup in retail

Trying to help, not sure it was appreciated!

Filed under: Uncategorized — pharmacychick at 10:04 pm on Tuesday, January 8, 2013

So…. as we all know its the new year.  I wrote some of my best wisdom a month or so about some of the things patients should be made aware of prior to the new year.   Since my customers aren’t aware that I write this famous ( or not) blog, they aren’t able to benefit from this amazing diatribe.  One such customer is Stan.

Stan and his wife are in their 70’s and both are on Medicare D…and Mrs Stan is on a medication that I suspect is being dropped from the formulary in 2013 because when I filled it Jan 5, I got a response from insurer…” transition supply limited to 31 days”.  To complicate matters, they tossed in the fact that they want an early refill in a couple of weeks because they are vacationing in the desert and didn’t want to be bothered with transferring it…( sigh).  So, when they came in, I made a point of printing it out, and explaining in detail what that possibly means and that they have all month to call the insurance and find out if they will have continued coverage or not. ” Because if you dont, its possible that later this month I can give you only ONE DAY worth of meds because you already have 30 days filled.”

I made it abundantly clear that  its important that they call as soon as possible.

He didn’t seem to want to make the effort, saying ” Ill just pay for it” until I informed him that the rx would cost him a bit over $400…EACH MONTH.

He Harrumphed a bit and added this bit  “Have YOU ever tried to CALL an insurance company?” and walked off.

You are kidding right, Stan?

Sadly for the benefit of the many, I occasionally have to sacrifice the few, so Stan, YOU have to call the insurance because I can’t sit on hold for a half hour for ONE patient when 50 others wait…especially when this isn’t my problem.  I am not a bettin’ woman but I’d put a few cents on the chance he doesn’t believe me and fails to make that call.

The ball is in his court.  I guess we will see what happens when I transmit that next claim.

3 Comments »

Comment by The Candid Pharmacist

January 9, 2013 @ 11:59 am

We are pharmacists not insurance brokers!

If patients took more responsibility for the financial aspects of their health care instead of expecting it all to be paid for in advance by a third party our health care system would be much more efficient and overall costs would be lowered.

No chance of that happening in our entitlement society.

Comment by Pharmacy Jim

January 9, 2013 @ 9:12 pm

Most patients don’t know and/or don’t care about their insurance until the pookie hits the fan. Then it’s our fault. For those of you who do take responsibility, let me say a hearty THANK YOU!

Comment by Jade

January 14, 2013 @ 3:33 pm

I don’t get the whole bit about entitlement and political correctness.

It is disingenuous to say that all our patients are members of an entitlement society. I am 55 years old. I have been working as a pharmacist for 25 years and in health care for 35 years, starting as a hospital volunteer in high school and then as a geriatric nurse aide in a nursing home.

Both my parents served in the military. They received educational benefits from their service under the G.I. Bill. True.

My father had a pension from his retirement from the city as well as professionally negotiated Teachers Union retirement package.

My father was conscientious about maintaining a healthy lifestyle (no alcohol, tobacco, diabetes, and plenty of exercise) and if anything he tried to minimize use of medical, and dental services.

When he was dying in his 80s, (might I say that there was less than six months between his acute illness and his death) and he paid his own way for health care from money he had contributed monthly to the insurance from his prior to retirement as well as what his wife contributed to negotiated group insurance program as she continued to work.

It was no question that my father had been ‘gypped’ so to speak for the long-term input of money to the healthcare industry for what he ‘got out of it’. And, even, utilization of the VA health system was minimal due mainly to the rapidity of his final illness.

Now, my mother in her mid-80s feels reluctant to use the VA services when she needs in-home assistance, and consistent medical care.

“But, Mom, you cannot afford the outrageous (and arbitrary) costs and pricing of drugs and the warfarin monitoring. Don’t feel about about asking for help from the VA. You made your contribution for 4 years in the Air Force at the peak of your energy, and you have always tried to contribute. Now, it is time for you to ask for help. Your kids have your grandkids’ school costs, and other living expenses, and we cannot help you (like we would want). And, if anyone deserves help, you and Father, have done your best all these years to provide well-educated, self-sufficient, healthy citizens to society.”

I do not get why people carry on and on about ‘entitlements’. Of course, our military, and our retirees, and our elders, and those unable to help themselves are ‘entitled’.

Especially, when those with money arbitrarily drive up healthcare costs forcing companies to maximize profits to the stockholders.

The bottom line. People who are not sick, nor have any previous reason to think like a sick person, do not know, and cannot fathom why ill people are surprised at the hoops and obstacles and complexity in negotiating for services they’ve been contributing all their life and up to the point of being ill, have never needed to use.this post wasn’t about entitlements, but your comment was well written. In my opinion that which you wrote about were all earned benefits from the service they provided.

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