Paying twice the copay after the third fill

Does anyone do this because home delivery is so bad that you are willing to pay more for a 30 day supply rather than get a 90 day? There’s something to be said about the convenience of having your prescription in your hand that day, and not talking with endless express scripts agents who can never help you.

On the other hand, it does eat a hole in the budget.

So curious what choices people make.

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u/AdAdmirable1583 — 23 hours ago

Lakewood Woes. Is there anything Lakewood can do when a heat cycle approaches? Do we flood PUCO? I myself live in a different location around the CLE, but am angry for my brothers and sisters and what they go through like clockwork in Lakewood when it gets heat.

u/AdAdmirable1583 — 4 days ago

Breaking Free

What is the way to do it? Wait till next enrollment cycle and hope there is another plan that offers retail fills

So many people have said:..”I just gave up and left them”. Like, how? Especially if the insurance company forces you to stay. Do some of you pay out of pocket with things like GoodRx after your 3rd fill?

Is there any workaround? Sincere questions from a struggling guy.

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u/AdAdmirable1583 — 4 days ago

Explain it to me like I am two

You have no choice but to use them. They give you three refills at the brick and mortar pharmacy and after that you have to pay the full retail price. They routinely deliver your medications late and you have no recourse. No accountability, no nothing. Representatives take no notes. You can call 14 times and each representative won’t know about any of the previous calls, so you start from complete scratch each time like Adam Sandler in 50 first dates. They won’t write up a ticket or anything, or have someone call you back. They give useless answers that don’t help.

How is cornering a business like this legal? I understand PBMs exist and all this stuff, but this really seems like mafia tactics to me. “You have to use our services no matter how shitty they are, and even if we put your life in danger”. Truly, I don’t know how this is allowed.

(Disclaimer: These are just my opinions)

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u/AdAdmirable1583 — 4 days ago

Late Meds

Does this happen to anyone else, especially "certain" prescriptions that take longer to process?

Because Express Scripts won't begin processing until literally like 2 or 3 days before you run out, plus the processing speed and shipping (3-5 days), I am constantly dealing with this issue. Sure, I pay for the one-day shipping, but that still doesn't limit the processing time. It truly feels like they don't care if I get my medication late or on time.

I really wish I could find a plan this open enrollment period that allows me to use a retail pharmacy without financially punishing me. These schemes that basically force you to use their mail order pharmacies should be illegal. I know there is a bill in my state proposing this, and I hope it passes. Not overly optimistic.

If you have had this same issue, what have you done to try to fix it so it doesn’t recur? Does hiring a patient advocate make any sense?

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u/AdAdmirable1583 — 5 days ago

Late Meds

Does this happen to anyone else, especially "certain" prescriptions that take longer to process?

Because Express Scripts won't begin processing until literally like 2 or 3 days before you run out, plus the processing speed and shipping (3-5 days), I am constantly dealing with this issue. Sure, I pay for the one-day shipping, but that still doesn't limit the processing time. It truly feels like they don't care if I get my medication late or on time.

I really wish I could find a plan this open enrollment period that allows me to use a retail pharmacy without financially punishing me. These schemes that basically force you to use their mail order pharmacies should be illegal. I know there is a bill in my state proposing this, and I hope it passes. Not overly optimistic.

reddit.com
u/AdAdmirable1583 — 6 days ago
▲ 2 r/autism

Meltdowns from dealing with health insurance

My insurance company in concert with the PBM forces me to use a mail order pharmacy for prescriptions or they charge me an arm and a leg to use retail. As an autistic person, this drives me crazy. Many times there are delays in shipping or processing and I run close to being low or running out. Being able to just drive down the street to the drugstore to pick up my medication would make me feel like I was more in control of things.

That probably feels like a silly thing to list as one of the things that can cause meltdowns for me, but it is.

I wonder if anyone else can relate?!

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u/AdAdmirable1583 — 14 days ago

Tom Campbell (My Big Toe)

Does anyone have an opinion of this guy? Apparently, he thinks we all remain in the sim indefinitely and does not promote “escape”. Was rather depressing to read. I know he was a colleague of Bob Monroe and a NASA physicist. Just curious what the consensus on him is.

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u/AdAdmirable1583 — 2 months ago