Presciption Drug Plan Tied to Medical Annual Deductible
I'm a retired AT&T employee that has Medicare as their primary insurance and my secondary coverage is through AT&T.
This year my selection process did not indicate what company would carry my secondary insurance.
The options were labeled AT&T Standard and AT&T Option 1 with the Opt.
1 allowing you to "buy down" the out of pocket expenses.
My secondary coverage for the last 4 years had been Cigna and since AT&T provides my secondary coverage I selected the AT&T Standard plan.
After the close of the enrollment period I received a new medical card in the mail indicating I was now United Healthcare.
I carefully went back over the enrollment information which at that time was only around 4 booklets and didn't find United mentioned anywhere.
Packet after packet began to arrive from Caremark which clearly was stated as replacing Medco mail order pharmacy with co-pays of $8.
00 for generic; $17.
00 for preferred and $35.
00 for non-preferred 90 days supply.
I promptly get online to set up my new account in which to track and reorder refills only to find that two of the four drugs on file had not come over from Medco.
My next visit to the Dr.
I request they send the two medications to Caremark that are not showing available for refill which they did.
A couple of days later I receive a call regarding a refill of a drug that previously cost me $66.
00/90 day supply that will be $318.
20.
It is at this time that the customer service person advises I have an $1100.
00 deductible that must be met of medical and pharmacy costs out of pocket.
Yes, for the first time the deductible for medical and prescription drugs are now tied together.
Being a primary Medicare patient I have a $100.
00 medical deductible per year and I would never have another $1000.
00 in medical visits within the year to pay this deductible so it will be all prescription drug deductible.
After now looking for this clause in the enrollment it is in the fine print that the medical deductible must be met before the co-payments for prescription drugs are in effect.
Looking further I now see under the AT&T Standard and AT&T Option 1 is the United Healthcare link that is not allowed in this article with "my" in front of it in very small letters or "My United Health Care" web site which is the only indication prior to enrollment closing to give a clue as to who the medical coverage is provided by.
At the time of enrollment and before getting the UHC card in the mail this web site meant nothing to me.
Meanwhile, my husband's Blue Shield plan for the federal government enrollment has closed and I could have been added to his cheaper than this deductible.
I now have a stack of books, some marked SBC, others marked AT&T some of which look to be duplicates of one another but have different stock numbers.
I am replacing my Nexium with OTC and taking the drug list from the Walmart Pharmacy to my doctor to determine what $4.
00 generic drugs will replace my other three medications.
I don't give Walmart credit for much, but they have used their bargaining power to the overall good in the bargaining of prices on generic drugs, a lesson our government could use.
Essentially I do not have prescription drug coverage now and I'm sure this was an overall plan that in my case is working.
I dread to find out what maybe lurking in this stack of books that has yet to be uncovered.
This year my selection process did not indicate what company would carry my secondary insurance.
The options were labeled AT&T Standard and AT&T Option 1 with the Opt.
1 allowing you to "buy down" the out of pocket expenses.
My secondary coverage for the last 4 years had been Cigna and since AT&T provides my secondary coverage I selected the AT&T Standard plan.
After the close of the enrollment period I received a new medical card in the mail indicating I was now United Healthcare.
I carefully went back over the enrollment information which at that time was only around 4 booklets and didn't find United mentioned anywhere.
Packet after packet began to arrive from Caremark which clearly was stated as replacing Medco mail order pharmacy with co-pays of $8.
00 for generic; $17.
00 for preferred and $35.
00 for non-preferred 90 days supply.
I promptly get online to set up my new account in which to track and reorder refills only to find that two of the four drugs on file had not come over from Medco.
My next visit to the Dr.
I request they send the two medications to Caremark that are not showing available for refill which they did.
A couple of days later I receive a call regarding a refill of a drug that previously cost me $66.
00/90 day supply that will be $318.
20.
It is at this time that the customer service person advises I have an $1100.
00 deductible that must be met of medical and pharmacy costs out of pocket.
Yes, for the first time the deductible for medical and prescription drugs are now tied together.
Being a primary Medicare patient I have a $100.
00 medical deductible per year and I would never have another $1000.
00 in medical visits within the year to pay this deductible so it will be all prescription drug deductible.
After now looking for this clause in the enrollment it is in the fine print that the medical deductible must be met before the co-payments for prescription drugs are in effect.
Looking further I now see under the AT&T Standard and AT&T Option 1 is the United Healthcare link that is not allowed in this article with "my" in front of it in very small letters or "My United Health Care" web site which is the only indication prior to enrollment closing to give a clue as to who the medical coverage is provided by.
At the time of enrollment and before getting the UHC card in the mail this web site meant nothing to me.
Meanwhile, my husband's Blue Shield plan for the federal government enrollment has closed and I could have been added to his cheaper than this deductible.
I now have a stack of books, some marked SBC, others marked AT&T some of which look to be duplicates of one another but have different stock numbers.
I am replacing my Nexium with OTC and taking the drug list from the Walmart Pharmacy to my doctor to determine what $4.
00 generic drugs will replace my other three medications.
I don't give Walmart credit for much, but they have used their bargaining power to the overall good in the bargaining of prices on generic drugs, a lesson our government could use.
Essentially I do not have prescription drug coverage now and I'm sure this was an overall plan that in my case is working.
I dread to find out what maybe lurking in this stack of books that has yet to be uncovered.
Source...