Blue Cross / Blue Shield of Alabama - and Merck-Medco Pharmacy - prescription troubles

Complaints.com received the following consumer message on March 8, 2002:

From: Bj Rhein [Email User]

Blue Cross / Blue Shield of Alabama - and Merck-Medco Pharmacy - prescription troubles

Complaint about my health insurance company Blue Cross/Blue Shield of Alabama and Merck-Medco Pharmacy.

I had been obtaining my prescriptions at a local pharmacy, but decided to change to the mail program. Sounded easy enough--no waiting in line at the drugstore, using internet for renewing, and flat fee for 90 day supply.

Before attempting my first mail transaction I called to see what I needed to do to change over. I was especially wondering about my Maxalt-MLT, which is taken prn (as needed) for migraines. It can take between one and three tablets to get rid of migraine, but the tablets are effective. They are taken at first onset of a migraine, so it's not a daily medicine, but difficult to judge how often or how many will be needed and I was to ask the doctor to specifiy how many tablets I needed for 90 days. The doctor faxes this info directly.

My doctor did as directed. I received approx 1/4 of the number of tablets my doctor specified. I immediately reached for the phone to check on the error when I saw on a paper that accompanied the order that my order was being split between pharmacies (don't you just love it when they tell you something is being done for your convenience, but you can't see how). Anyway, I felt badly for almost complaining when obviously there were more tablets on the way.

The long and the short of it is that they were referring to my total order being split (Maxalt and others) such that other meds were forthcoming but not more Maxalt. I finally realized this when I was down to 2 tabs. I called to find out what was going on. I was told this medication required "prior approval" to receive more.

I asked why I wasn't told this when I originally called and why there was no mention of this in the paperwork. It seemed to me that if they weren't sending the rest they should have at least informed me. The young man said I had been misinformed during my original call and he didn't know why the customer isn't told.

So, anyway, had to contact my doctor again so she could call the phone number for prior approval. Of course, it took a couple days of phone tag to get it straight that the prescription was okay, but had to have the phone call. (By this time, I have 0 pills left.)

Then I call BC/BS-merck again to be sure all is well. The lady tells me it will take 72 hours to process. (This is Friday, so of course it's even longer than that b/c Sat/Sun don't count.)

Each day I log on to website to see if my med is sent. No mention. So I call again. Get this. I'm told that it takes 7 days (which is true when you start up), but it was my understanding someone was watching for my info to come through. So the girl says she'll send it on, but she can't guarantee when it will actually be sent b/c that's done somewhere else.

She tells me to call back that afternoon and she'll be able to tell me. I call back and get someone else, explain it all again and get the run-around again. By this time, I'm pretty mad and ask for a supervisor. I talk to this lady who assures me she'll call me the next day (i.e. today, Friday) around noon. I tell her not to leave message on home answering machine. If I'm not there, to call me on cell phone. She agrees.

Did I get a call? Of course not. So, this afternoon I call and she is away from phone. So I call again so I can talk with someone. Get to explain everything all over again. Still don't know when it will be sent. I made no bones about being extremely upset b/c I had no med (he says whatever he's looking at says I still have med).

He says I should get another rx from my dr to cover me till they send some. I explain the doctor's office is closed on Friday afternoon. He points out there's always an emergency number. that made me even madder. I asked for someone with power. His super walked through the door and he said his super would call me by 6 (pm). You guessed it--no call.

So here I am typing this. By the way, not mentioned above is how much time it took for each phone call and how many different numbers I had to call. Apparently, BC/BS of AL contracts out with Merck-Medco to handle the prescriptions, but the approval is provided by BC/BS--though even this isn't clear.

I call one number and I'm told "they" don't handle that and to call another number, and "they" tell me something else. Very poor communication between the two companies--don't know if that's part of the design. It give them someone else to blame.

Also, the prescribing doctors name is incorrect on several of my other prescriptions. When I pointed that out, I was told to call them the next time I get them filled and they can fix it then (can't fix it till then). Sure doesn't give me warm fuzzies about their competency.

Thanks for letting my have my say.

Comment On This

I could have written this letter myself! The history that was displayed in the letter is very similar to mine. I am on a pain medication after suffering from a broken neck 23 years ago. My doctor has been prescribing the medication for about 15 years. After having to pick it up once a week I finally decided to use Medco's mail in program. It was wonderful at first but for the last 3 years or so the have insisted on my going through a "PRIOR AUTHORZATION" PROCESS. My doctor and I did what they require and we were informed shortly thereafter that the appeal was successful. When I ordered my refill they found no problems. Then on the day the medication was to arrive a representative from Medco called to say the approval was for a smaller mount than my doctor and I had requested and that it would not go out until Nov.! That means 3 weeks with no medication. Besides the pain I will be in I will also have to go thrugh a withdrawal from the medication. This has happened before due to Medco's policies and my doctor says it is the same as withdrawal from Heroine or Morphine! At his point I'd like to speak to an attorney! I'm just not certain on how to go about suing them for pain and suffering along with breach of contract. Frustrateddoesn't even begin to cover how I feel!