Tuesday, October 14, 2014

How A Simple Medication Refill Turned Into A Disaster

I've fallen down the rabbit hole. There is no other possible explanation for what's going on.

My prescription plan is through one of these mail-order pharmacies, Optum Rx. While I can go to a retail pharmacy for short-term prescription like if I need antibiotics, all of my long-term meds have to come through the mail and it has to be a 3 month supply. Last month I called to refill my existing prescription for my rescue med (Sumatriptan). About a week later they arrived in the mail box. Well, some of them arrived - 25 pills of the 54 pills that were prescribed.

First of all, 25 is not divisible by 3. There is no math that allows for a 3 month supply of pills to equal 25 pills. I was able to get them to send me 2 more pills cause they showed my plan was supposed to allow 27 for 3 months (WRONG - I have a long-term preapproval for 54) but they told me I wasn't allowed an explanation as to what happened. I'm left believing they are scamming me, holding 2 pills back and hoping I don't notice, saving them money. Second of all, why are they sending me less than half of the prescribed amount? If there is a problem, either my doctor's office or the pharmacy should have contacted me. Instead they sent the pills, told me there was nothing they could do to correct the problem for this 3 month time period and insisted I pay for them and they would help me resolve the problem for next time. Turns out all of this was wrong or a lie. Does it even matter which?

Anyway, this was the beginning of a month long battle with both Optum Rx and my doctor's office to try and resolve this problem, a battle that rages on STILL. I've talked to at least a dozen people between the two places and absolutely everyone I've talked to has told me something different. Each and every conversation has made the problem worse and more confusing, taking me deeper and deeper down the rabbit hole.

I feel like I'm speaking a different language and everyone around me is just nodding along and pretending to understand me. I'll save you all the lengthy, confusing details and just say that it is not an exaggeration when I tell you that every single aspect of this ordeal has been screwed up. Up until this past weekend I though it was only Optum Rx that was Screwing up but now I know that it is also my doctor's office.

 I'm supposed to be managing all of this but I'm the only one who doesn't have access to the actual details. I call my doctor's office and they tell me one thing. I have no way to verify what they tell me but no real reason to believe they would be lying to me. So I call Optum Rx and relay the information and they tell me that is not what their records show. So they send me back to the doctor's office or onto someone else within their company who tells me something different still. I feel like I'm seriously going mad here.

I've lost hours playing this maddening back and forth game with them. Remember, all I was trying to do was refill an existing prescription that was previously correct. How the hell did it get this messed up!?!?!?!?!?!

I'm so angry. I don't deserve to be treated like this. Nobody does. Not only have they stolen a tremendous amount of time and energy from me but there has been a mental and emotional cost as well. Living with chronic pain is hard enough, the last thing I need is this level of bullshit and extreme incompetence. I've lost all faith in both Optum Rx and my doctor (and her employees). If they can't handle something as simple as a medication refill how can I trust them with anything.

At this point everything is on hold until I can get in to see the doctor on the 21st. I'll have to spend an hour on the road and pay my co-pay to resolve the clusterf*$% that this refill has turned into. Everything about this is wrong. None of this would have happened if I was allowed to go to a retail pharmacy.

1 comment:

  1. Oh my gosh! this is crazy! Simply crazy! I sure hope they figure this thing out and you get allllllll you rescue meds. You so don't deserve to be treated this way!