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insurance requiring use of mail order for prescription drugs

Posted Jan 20 2012 11:54pm

Lately, the financial effects of this stupid disease have been bearing down hard. It’s not enough that everything else is, well, stressful at times, the financial effects of stage 4 cancer bring their own brand of insomnia as well.

Medical bills are enormous, always exceeding any budget and providing a constant worry about whether you will lose your treatment simply because of the inability to keep up with the financial toll. As if this is not enough, the insurance we have recently contacted me to let me know that I can no longer purchase prescriptions from a retail pharmacy but am required to use a mail order company for the ongoing medications I take. These include four for blood pressure and one for cholesterol. I may be required to take something again for my diabetes, but that has been on hold because of the kidney function issues I have had from the Zometa®, which was discontinued and replaced by Xgeva®.

The issue now is that the retail pharmacies that I can use near where I live are less expensive than the mail order company that our insurance is requiring me to use. We do not have a choice as, presumably, my husband’s employer has contracted with the insurance company and included this particular requirement in the overall insurance plan.

It is a problem for us who have so many bills that a $10 or $15 copay is overwhelming when five or more medications are involved every month. It would appear, once again, that the insurance company and the pharmacy here win out over the patient. Ironically, I know that friends who have used this mail order company have paid far less than retail pharmacy prices, but that was before local pharmacies appear to have become more competitive. I know that in checking with various local pharmacies, I was able to find the best deal and cut my monthly medication bill by a significant amount of money. I will no longer be able to shop for the best pricing for my budget.

This is the first time that I have heard of a mail order company being more expensive than retail pharmacy and also requiring that subscribers fill prescriptions through them rather than shopping for the best deal on the price for the patient. I will need to get over it, but having been on the phone with this company over and over about approvals from the doctor’s office has gotten on my last nerve, especially when comparing the service from the local pharmacy, at a lower price, who handled obtaining approvals completely without my intervention.

That is the last of my thoughts on cancer for this week. The weekend is here, and I am heading for the oasis. No thoughts of this stupid disease at all.

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© 2004–2012 Donna Peach. All rights reserved.

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