DammitJanet
Well-Known Member
I went to the doctor yesterday and he prescribed me a nebulizer, advair and albuteral.
I have Medicare (Part A and B), Medicaid and Medicare Part D Drug coverage. You really need a college degree in all this to understand it but basically Medicare Part A is hospital, Medicare Part B is doctors and Medicaid is what picks up my copays for my medicare premiums and the deductible's for Medicare and all the copays, plus it covers my donut hole in the Part D.
Well. I go yesterday and turn in the scripts for the albuteral and the advair to the pharmacy. I also asked them where to get the nebulizer. They told me where to go. Then they looked at the albuteral script and told me that it wouldnt be covered by my Part D, I had to get it from the place I got my nebulizer. HUH? Ok...so I take it and go to that place...thoroughly confused.
I get there and they are confused because they only do nebulizers and no drugs. Just what I thought. So I get the nebulizer and go back.
They say,...oh we cant do the albuteral because there is no diagnosis code on the script. HUH? The diagnosis is written on the script! My doctor is now closed! No way to reach him. They tell me if it was being filled through my Part D or medicaid they wouldnt need the diagnosis code but since my Part D or Medicaid dont pay for albuteral, it has to go through my Part B and has to have the code. Makes no sense. Part B is Doctor...also they say I have to pay a portion...50 bucks because I havent met my deductible for the year!!!
Excuse me? I dont have to meet a deductible!
Of course, my cellphone is dead. Im sick and cant deal with this. I need this medication. I just got the stupid machine and its worthless without the medication.
I go back to the store I got the machine from and get the code for asthma and write it on the script. Go back and get the medication. Yes illegal. So what.
I end up paying what they want. I get my medications and come home.
I finally open everything up and do my treatments. Feel better.
Look at the Advair box. Read the label. OMG...It is mislabeled. Advair is a maintenance medication which is supposed to be taken twice a day. One puff twice a day. The insert says that. My doctor told me that. The little dohickey is round with only 60 doses.
The label reads : TAKE 1 PUFF EVERY 2 HOURS
I am assuming that would lead to a massive overdose.
I called Medicare last night to try and get to the bottom of why I was charged for my albuteral. I have to say Medicare is so very helpful. They were astounded. They told me that I shouldnt have been. Albuteral is covered on my Part D drug plan. I should have paid a $1.10 copay. No way should a drug store have been filing anything under my Part B coverage. My medicaid does cover me just the way I think it does, I am not out of my mind. I am to go to DSS on Monday and show them this paperwork and they will refund me my money.
I am seriously thinking about changing pharmacy's. I have been with this pharmacy for years now. I have had one other problem with them. This though is rather major.
I have Medicare (Part A and B), Medicaid and Medicare Part D Drug coverage. You really need a college degree in all this to understand it but basically Medicare Part A is hospital, Medicare Part B is doctors and Medicaid is what picks up my copays for my medicare premiums and the deductible's for Medicare and all the copays, plus it covers my donut hole in the Part D.
Well. I go yesterday and turn in the scripts for the albuteral and the advair to the pharmacy. I also asked them where to get the nebulizer. They told me where to go. Then they looked at the albuteral script and told me that it wouldnt be covered by my Part D, I had to get it from the place I got my nebulizer. HUH? Ok...so I take it and go to that place...thoroughly confused.
I get there and they are confused because they only do nebulizers and no drugs. Just what I thought. So I get the nebulizer and go back.
They say,...oh we cant do the albuteral because there is no diagnosis code on the script. HUH? The diagnosis is written on the script! My doctor is now closed! No way to reach him. They tell me if it was being filled through my Part D or medicaid they wouldnt need the diagnosis code but since my Part D or Medicaid dont pay for albuteral, it has to go through my Part B and has to have the code. Makes no sense. Part B is Doctor...also they say I have to pay a portion...50 bucks because I havent met my deductible for the year!!!
Excuse me? I dont have to meet a deductible!
Of course, my cellphone is dead. Im sick and cant deal with this. I need this medication. I just got the stupid machine and its worthless without the medication.
I go back to the store I got the machine from and get the code for asthma and write it on the script. Go back and get the medication. Yes illegal. So what.
I end up paying what they want. I get my medications and come home.
I finally open everything up and do my treatments. Feel better.
Look at the Advair box. Read the label. OMG...It is mislabeled. Advair is a maintenance medication which is supposed to be taken twice a day. One puff twice a day. The insert says that. My doctor told me that. The little dohickey is round with only 60 doses.
The label reads : TAKE 1 PUFF EVERY 2 HOURS
I am assuming that would lead to a massive overdose.
I called Medicare last night to try and get to the bottom of why I was charged for my albuteral. I have to say Medicare is so very helpful. They were astounded. They told me that I shouldnt have been. Albuteral is covered on my Part D drug plan. I should have paid a $1.10 copay. No way should a drug store have been filing anything under my Part B coverage. My medicaid does cover me just the way I think it does, I am not out of my mind. I am to go to DSS on Monday and show them this paperwork and they will refund me my money.
I am seriously thinking about changing pharmacy's. I have been with this pharmacy for years now. I have had one other problem with them. This though is rather major.