Maybe someone can offer some insight as to what is goin on here.
On 12/2/08 I get a call from hubby...he's out of state driving...he'd received a call from his terminal manager stating that we no longer had Anthem insurance but had Unicare instead. This change was apparently effective on 12/1/08. We had no prior knowledge to this change at all. That being said, the pharmacy declined my son's prescription.
I make a phone call to Human Resources to find out what is going on with this. I'm told to go to the doctor's office, get a script written for a single fill of the drug and take it to the counter at the local pharmacy. I asked him what our coverage is and am told "You have the exact same coverage as before. Nothing has changed, just the name of the provider." Ok, not a problem, the script should be $15 at the counter or 3 for $30 through the mail.
I get the script and head out to the pharmacy only to be informed at the counter that I have no coverage. They want $232 for this prescription. I go home, call H.R. up again and he tells me that there's been a delay getting us "into the system" and that we do have coverage, it will just take a few days to get us set up. My son had about ten days of his medication from the sample left at this point.
I wait a few days, get a call from H.R. that we're in the system and that I should be able to get my prescription filled at this time. I call ahead to the pharmacy to save time. I'm informed that the medication is now only $191. WTF!!! At this point I call the insurance company only to be told that they can't tell me anything about my coverages...the only person they can talk to is the pharmacist. WHAT!?!?! Is the pharmacist paying my premiums?? I think not!! I'm pretty sure I escalated to a sucky customer at this point.
When I get off the phone with the insurance I call H.R. again...this time I'm told that we ARE in the system but we were put in under the wrong group number....niiiiiiice. He tells me that it should be fixed in a couple of days. By now we're down to about 5 days of medication left and I'm getting nervous. Without this medication my son turns blue on a daily basis. I wait a couple more days and get a call...during an ice storm...that we're in the system, all meds are a go and I can go get my sons medication. The next day the ice had stopped so I made my way to the pharmacy and got the script for $15 just like it should have been.
Since we're good to go on the insurance I call the doctor's office and ask the nurse to write up my son's Advair as well as my birth control (that should have been re-ordered on 12/3) for mail order. I pick up the scripts and get them in the mail, with the appropriate checks, based on what we'd paid for the past 11 months. On Friday this past week I get our prescriptions in the mail along with a bill for $50. Now they're saying his Advair is 3 fills for $70 instead of 3 for $30 and my b.c. is $20 instead of only $10. Time to make another call to H.R. to find out exactly what our coverages are because obviously a $50 difference is not "the same as you had before".Hopefully this comes to an end soon. I'm so frustrated at this point. Insurance companies just plain suck!!
TLDR? Insurance change, denied scripts, took ages to get fixed, now overcharging for scripts.