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 Being Retired now, I thought that it was time for a new name to this Blog |
Prescription Insurance Issues Well, it appears that I've been terribly naive about my prescription insurance. Don't get me wrong, everything's been good, all covered so far, but I'm learning what's really been happening as each day passes. Allow me to explain what I'm talking about please. As some of you might know, I was diagnosed with Multiple Myeloma in 2021, and started Chemo-therapy in June. I've been taking the Oral Chemo Drug Revlimid for 4 years now, Cigna has covered it this entire time. I've also have Tri-Care 4 Life as a result of my Military Service. So it too was being billed, or so I thought. I take Revlimid for three weeks, then a week off the medication, and repeat. As I said, I've been doing this for 4 years now. Also as many of you know, I retired from Motorola on May 2nd, but was still covered by Cigna through the end of May. As fate would have it, I had Revlimid refilled just before the end of May. Well, last week was my 'week off' Revlimid, and as always, I called Accredo On-Line Pharmacy to get the Revlimid filled again. Yes, this is an online Pharmacy, you cannot get a Chemo Drug refilled at CVS or Walgreens, or other neighborhood Pharmacies. Last week I learned that Accredo had to 'straighten out' the Insurance, essentially drop Cigna and make the DoD (Tri-Care) my only pharmacy insurance. I was told it would take until late this week for that to happen. I had a hard time wrapping my head around that thought, but I did just let it go. Today I received a text from Accredo that my prescription was ready for refill, so I called them about it. Easier said than done. Their records showed I had NO Prescription Insurance. I told the young lady that that was impossible, I have Tri-Care for Life until I leave God's Green Earth. To make this already lengthy entry a bit shorter, she had their Tri-Care department join the call. And it turns out that Tri-Care has never been billed for my Prescription Coverage. Tri-Care should have been payingt whatever Cigna didn't pay, for 48 months, at $16,000 a month! (At least I've never paid a penny for this, my portion has always been Zero). The one good thing here, is that this isn't my problem, it's not something I need to get cleared up. BUT, to get Tri-Care to cover my prescription, I need a 'Prior Authorization'. My main thought is, I told them in 2021 that I had Cigna as my primary pharmacy coverage, and Tri-Care as the Secondary. Why is it that 48 months later, they are just getting a Prior Authorization set up? Why wasn't I informed about a Prior Authorization needed last week? I'm just shaking my head over this. And of course, I was supposed to start taking Revlimid last Saturday. Today is the fifth day I haven't taken it, and it will likely be 2-3 more days before everything is straightened out. Monday? I'm not making any bets on that. Thank God I'm in Remission and am okay, as far as I know. Yep, this is our wonderful Medical System that takes such wonderful care of us all. |
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