I am 63 and have had to take Dexedrine ER, usually from 120mg to 150mg, every day since I was 39. I had ADHD as a white trash kid but was not treated. I got into UC Davis and ended graduating from UC Hastings. Four years into my career a guy driving 80 veered into our lane and but us head-on. My 4 month old in back was somehow safe . I was knocked out cold for 10 minutes.
, my wife was pinned in and screaming because she right I was dead. But we made. I returned to work for my law firm 14 months later. Just didn’t have energy for 60 ĥr weeks so moved to further East in California -el Dorado county to become county attorney. Meanwhile was diagnosed with add and dashed taking stimulant. Then damn if the mirror image head-on occurred and that pretty much knocked me out of the law business.
All this is prelude to my real story which is that living where we live in rural-ish, there can be months and months on end with difficulty finding a store to fill one of the schedule 2 amphetamine. Until I found a nice neither store which for five years worked like clockwork to have the full amount 60 straight.
Then came 61. Drop off add usual cine back with a sofa only this time the clerk says , Mr K, our new pharmacist says she won’t fill. Why? Mumble. I get the pharmacist down off the pedestal. Something about only one supplier my insurers reimburse us enough to only make a small profit.
Filed under: General Problems
@the OP that emailed Pharmacist Steve: It’s an excuse. If they are a contracted pharmacy in the network, they cannot refuse to fill the script based on what the third party payer reimburses. You need to call the help line number listed on your insurance card and tell them what you were told. The pharmacy is contractually bound to fill the prescription unless there is some matter of the laws, rules and regulations governing the practice of pharmacy that require some form of remediation before the pharmacist can legally fill the script. From the described scenario, the only barrier seems to be one of a financial nature and as the pharmacy agreed to be a provider in the particular network that serves the members of your health plan, they either serve all the members of the plan walking through the door or they will end up serving none of them when the plan terminates them from the network for breech of contract (the logical endpoint where this will go if the pharmacy chooses to not budge).
If it helps any, I am a pharmacist and I am employed by a health insurance provider. I am a consultant and investigator on the audit and recovery unit where I work. I live one county to the north of you in Placer County. I have a feeling that you live in either the south end of the county near Amador County or the east end towards the state line as you described your living are as pretty rural; those areas are pretty far removed from any appreciable populations areas as compared to the rest of the county, as you are well aware of. If you wish to dialog with me personally, please email Pharmacist Steve your email contact information and your consent to be contacted by me and for Steve to release your contact information to me. He, in turn, can forward it all to me, if that is something that he is willing to do.
@ Steve…if you are comfortable forwarding me the OP’s (the sender of the email) contact info, proving the OP first consents to such, I will be happy to try and help him further.
Here in fl. it is EXTREMELY hard to get pain meds filled, especially oxycodone. I have cvs caremark ins. & had gone to cvs for over 10yrs. every mo & had same rx from same doc for 6yrs. W/o any notice I was told that they could no longer fill because my doc was not within 20mi. of cvs, yet they continued to fill my ambien & bp & heart meds from the same doc, but not my oxycodone. Can they do that?
I finally found a small pharm willing to fill & all was good for the 1st 8mo. during this time the oxy shortage got worse & I was told that they could no longer take ins. for my oxy because it was very hard to find & cost more than ins. would. A 30 day supply of 30mg oxycodone X 2 per day was about $25 w/ins, now the cash price for the exact same med. is $675, & this was a lot less than others were charging! Others wanted up to $1500!!
So the only way I could find it & afford it was to have it compounded; but even though it is 30mg oxy they also added ginger & naloxone. I know it is to keep people from shooting it or snorting it, I don’t know if the added ingredients change how it works; but I does not give me the relief & wears off a lot sooner than the reg. tablets due plus every time I take it it causes BAD heartburn & burning in my throat.
Also they require 3 non controlled rx’s to be filled w/ each controlled rx. They at least take my ins. for all the others I am forced to fill (only use 3 of the 6 that is required for my 2 pain meds) but I have to pay cash for the compounded oxy which is $231 per mo.
I thought price gouging & bundling was illegal; but I can’t say anything because I have no other choice. Are they allowed to do this?
If it is costing more now & I don’t mind paying what is left over after ins. pays; but I can’t believe that their cost went up that high unless they are buying it from drug dealers! Any advice would be GREATLY appreciated!!!
insurance sucks, that is whose fault that is. pay cash?