It was discovered 5 1/2 years ago that I have a birth defect on the left side of my heart that affects how it beats, as well as a murmur and few other things that require me to be on lots of medicine; I take fourteen different meds daily: twenty five pills daily plus two asthma meds. My siblings also have the same problems on varying degrees, I just have it worse. I've been using a particular Walmart's pharmacy since they opened seeing as they were the first one's to implement the $4.00 'scripts in my area. All of this was done against my doctor's advice, but she relented once she knew of my (former) job's crappy health insurance that basically only was covered if you used Walmart and my other financial issues. In 2009, I went on disability and and in 2010 I signed up with an HMO that had a zero co pay on generic meds and a $1.00 - $3.00 coverage for name brands.
Well recently, my HMO changed it's pharmacy coverage and required me to have a co pay that I was not aware of because all of my new info stated that none of my benefits had changed from the prior year. So I was surprised when I went to pick up my meds on 01/07 and had to pay. But pay I did. I contacted my HMO the following Monday and found out that I was some how re-enrolled into the program with the zero co pay, but it wasn't reflected in the pharmacy's system. So in a way that was the HMO's fault; there was a big mix up, but they honored their mistake and I'm back to having zero co pays... supposedly.
Suck the One:
I know for a fact that they contacted Walmart's pharmacy four times that Monday because they kept calling back to pass the messages on from the pharmacist and I thought everything was copacetic when I put in my refills this past Wednesday, I called to check on the progress on Friday and they told me that I still had a co pay. Called my HMO again and they spoke with the head of the Pharmacy again; she just needed to cancel said 'scripts and put them through again and the over ride would show as well as the directive to refund the monies from 01/07. I was told that everything should be fine and to go pick up my meds, but just to be on the safe side, I called and was told by the same pharmacy head that no one had contacted her and that I still had a co pay. Sigh. Called the company back and they're closed for the evening, but I can call the next morning.Cue day one missing some of my meds. I call early the next morning, I speak with the same worker, she calls the same pharmacists, same song and dance and and she hung up on the lady from my HMO! So I call for myself and get told the same thing about no one contacting them! Mind you, she just got off of the phone with my HMO not five minutes prior and the worker knew her name and described her voice exactly (it's rather distinctive) so there was no mistake. We get "disconnected". I try calling again, no one answers; repeat six times over the next three hours. I make the trip anyway (I was calling so much because the pharmacy is 90 minutes away and I don't drive) only to find out that the hours have changed and the closed two hours earlier than normal- instead of closing at 9pm they changed to 7pm; there was no notification about that when I was there the week before and they usually have signs all over stating changes in hours of operation. Okay, I'll have to make another trip the next day, make notes of the new hours, purchase a few things and head home. Cue day two missing some of my meds.
Suck the two:
I finally speak with someone face to face and am ignored on all levels. The tech kept insisting that I still had a co pay and when I explained to him for the third time what needed to be done he just acted like I said nothing, stared through me and just kept sighing finally asking "Are you planning on picking up or not?" I asked to speak to the pharmacist in charge several times, and only when the people behind me kicked up a fuss, did he say anything to her. I notice it's a different pharmacist from the one we spoke with, but it's such an important issue that I'm sure a message was left or something, so I move over to the consultation window to discuss the problem. I explained what the problem was, she stared through me. I also told her that I was there the night before but that the hours had changed. She went "Ha!" and loudly stated that they had the same hours for the last ten years and I'm making up a story. (I started using this Pharmacy when they first opened FIVE years ago, so yeah no.) I showed the receipt from the night before with the time, I also showed her the receipt from the Saturday before and the time was 8:55pm and there was no way that I could have made up my own receipt and I have no reason to lie.Her response was "But you probably are lying!" Loudly. With about eight people listening in on her end of the conversation. I was livid, I asked for her name and the number of the district manager so I can report her and she got really cocky, but when I whipped out my phone to make the call, she changed her tune. She tried to take back all that she said, calling me "Sister" and when I asked for one of the store managers she tried to tell me that there were none on the floor and that I'll be waiting a long time, but to tide me over she'll give me a dose of meds to make it through the night, which she did. At this point I was feeling so crappy from trying not to blow up at this woman that I just took it and told her I would return the next day.
Suck the three:
I called my HMO (again) spoke with the same people (again) they called there (again) and I finally returned to pick up my meds (again). I spoke with a store manager before going to the pharmacy and wound up getting my refund for the meds the week before as well as the number for the pharmacy's district manager, so that's a win. Head over to the pharmacy: same pharmacists, same song and dance. She told me that she called my HMO and they informed her that I had co pays. Finally fed up, I called the case worker and gave her the direct number so she can speak to her as well. There was a kind of a three way conversation with the case worker going back and forth with the pharmacist and me. She basically tells her the same thing about canceling the 'scripts and re entering them in the computer. I finally hear her give an affirmative answer. Yes! Sweet sweet heart medicine! Only to be told when she hung up, "I don't care what she says, you have a co pay, I'm not re entering this, and you can either wait until I come back from lunch or you can come back tomorrow to straighten up this mess." Thing is, the worker was still on the phone on my end, she directed to me to get the meds that had already been "gifted", cancel the rest and they'll begin the process of transferring me to CVS tomorrow morning.
Somehow I have a feeling they'll try to tie up my transfers....
tl;dr: Pharmacy doesn't believe customer or the HMO when trying correct a payment mistake. They lose a long term patron in exchange. My HMO is so full of win, I love them.
Edited to fix misspellings.