I have a prescription medication I take once every 3 months that isn't covered by insurance. Fortunately the out-of-pocket expense is doable. I take it the first Sunday of the month because I figured that would be easy to remember.
With the first Sunday of April being a holiday this year I decided to request the refill 2 weeks early. My pharmacy put it on hold because it wasn't covered by insurance. They did not contact me. To be fair I should have gone in much sooner to try and pick it up. But I thought, since I'd given so much time, that it would be there when I tried to pick it up on Thursday.
NOPE! My refill was on hold and they didn't have the medication in stock. I explained that I planned to pay out of pocket and asked them to fill the prescription. They said they should get the medication either Friday or Monday. We were unable to follow up on Friday or Saturday, so I called this afternoon to confirm its availability before going to pick it up.
I had to talk to an automated system. The prescription was listed as "fillable." So I said, "fill it." Time passed and I got no update so I called again and got the same result. I said I wanted to talk to a pharmacist. I was sent to voicemail. I left a message. I got a call back sometime later explaining that someone had tried to put the refill through insurance, it had been denied, so they had contacted the doctor asking for an alternative. The pharmacist said they would cancel all that and push through the original prescription. I thanked them, we wished each other a good day and hung up.
I waited. Nada. I decided to just go over there (it's a short walk) and see if I could pick up my prescription. I had another one ready but this one was still pending or something. When a pharmacist came to help me I said "can you please fill the one that's pending..." "You were here the other day, weren't you? Let me see if we have that in stock." They asked me to sit off to the side so I did, expecting to be called in a few minutes.
Time passed. The line got long. Everyone got helped. More people showed up. More time passed. The people sitting next to me chatted. Complained about how long they'd been waiting. I chimed in. They sympathized. Finally one of them got up and went to check on their order and lo, it was ready! They were kind enough to tell me what had happened and suggest I do the same. Sure enough, so was mine!
I'm really annoyed and frustrated. I can't really blame the pharmacists, though, especially since when I actually talked to them they seemed to want to help and were friendly. They were swamped. I'm mostly annoyed that they didn't contact me to try and resolve the hold during those 2 weeks. But, as I mentioned earlier, I could've been more proactive. I'm also annoyed with my past self.
Of course, none of this would have been an issue if the medication was covered by insurance! The form I take is the one I feel safer self-administering, which I find much more accessible than going to the doctor. I think it might only be available under a brand name, unless that changed recently, or perhaps it's more expensive than the alternative? My insurance only covers the generic version(s) of the other form. Whether it's due to legit concerns over cost or they're being stingy, it's hurting people.
Companies that develop medications shouldn't be able to sell them as an expensive "brand" and insurance should cover all forms of a medication that are proven to be safe and effective. Oh and we should have universal healthcare.
