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Medicare and Health Care


*This is a non-medical board. This site shall not be used to seek professional, medical or legal consultation.

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age person with End-Stage Renal Disease (ESRD). There are many different parts to Medicare; with all of these options, it can be confusing.

This forum will allow members to share their experience with medicare and seek advice* on certain medicare-related situations.

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jagfan  
#1 Posted : Wednesday, January 18, 2012 8:06:13 AM(UTC)
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I submitted two NEW prescription a few weeks ago using the forms included in the packet CR sent us in December.  Haven't rec'd the scripts yet so called Medco.  To make a long story short, according to Medco, they haven't rec'd the scripts.  When I verified the Medco address that the forms were mailed to, the rep said it was an incorrect address.  I then checked the forms on the Medco website and they have the same "incorrect" address (PO box 30117).
 
Anybody else under the Compass Rose Health Plan experiencing similar problems with NEW prescriptions sent to Medco?
martyb  
#2 Posted : Wednesday, January 18, 2012 8:31:08 AM(UTC)
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Glad you brought this up.  I haven't used the mail order program yet, but I'm about to start.  Thanks.
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Fed1969  
#3 Posted : Wednesday, January 18, 2012 10:52:47 AM(UTC)
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Hopefully this will be fixed real soon.
B47  
#4 Posted : Wednesday, January 18, 2012 12:46:54 PM(UTC)
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I am with BCBS and MEDCO was dropped at the end of 2011 and picked up by Caremark.

The MEDCO web site had that information when I just decided to test to make sure and it wouldn't let me in. I called the Customer Service # listed on my BCBS card and they helped me set up a mail order service with Caremark.

Perhaps it is different with other GE Health Benefits carriers.
jagfan  
#5 Posted : Thursday, January 19, 2012 3:12:39 AM(UTC)
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Fed1969 wrote:
Hopefully this will be fixed real soon.
 
After talking with three member service reps at Medco I contacted Compass Rose this morning.  The individual who assisted me was very proficient and said she would escalate the issue and get it resolved.  In less than 45 minutes, I rec'd a phone call from an individual at Medco (manager type) who intervened and had obtained and taken necessary steps to get my scripts processed.  She even gave me her direct phone number in case there were problems in the future.  An hour after the Medco call, I received an automated call from Medco that my scripts were in process and would be shipped no later than the 23rd.  I checked the website and my order order is now showing up with the shipping date.  I'm quite pleased with the rep from Compass Rose who was able to get the ball rolling.  Both she and the Medco manager were very responsive. 
 
Also, the address listed on our forms is CORRECT.  The information available to the Medco service reps was incorrect and is supposed to be fixed. 
upandup  
#6 Posted : Thursday, January 19, 2012 6:03:30 AM(UTC)
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Excellent. With any transition, problems are inevitable, but the response is important!

jagfan  
#7 Posted : Thursday, January 19, 2012 6:40:02 AM(UTC)
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Rec'd another call from the Medco manager - the scripts are on their way via UPS overnight delivery at no add'l charge to me.  I could not have asked for better service.  The key was getting management involvement.  The member service reps, although courteous, just couldn't push the right buttons.
B47  
#8 Posted : Thursday, January 19, 2012 7:16:06 AM(UTC)
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Can anyone explain to me why I received information saying that the FEGHB had switched from MEDCO to CAREMARK for mail order scripts service? Or is the switch only for BCBS members?

I am confused!
keeponkeepingon  
#9 Posted : Thursday, January 19, 2012 8:08:59 AM(UTC)
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I think that each carrier under FEHB has their own contract for mail order prescriptions. The Blue Cross contract may or may not be the same as Compass Rose or GEHA, and they are subject to change each year.  The mail order prescription service is not from FEHB, it is from your insurance company.
B47  
#10 Posted : Thursday, January 19, 2012 8:40:00 AM(UTC)
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You are probably correct. I will check with BCBS tomorrow.

Thanks
upandup  
#11 Posted : Thursday, January 19, 2012 1:59:40 PM(UTC)
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Yes, there is no unified prescription drug plan or pharmacy benefits manager (PBM) for FEHB. There has been talk of carving out prescription benefits or doing something else to provide for FEHB-wide negotiations with pharmaceutical companies, but that hasn't gone anywhere.
B47  
#12 Posted : Thursday, January 19, 2012 11:16:40 PM(UTC)
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I called BCBS and the Customer Service person confirmed what you said. So now BCBS uses Caremark for their mail order prescription service.

I didn't know that before - I thought Medco (in this case) provided all main order prescription service.

Live and learn.
deajv1  
#13 Posted : Monday, January 23, 2012 12:36:11 AM(UTC)
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I switched from CIGNA(via SAMBA) to United Health Care (via Compass Rose).Before switching, I checked that MEDCO, who has my Rxs will be honored. On Jan 1, I called MEDCO to renew a RX and they did not have me registered with Compass Rose, but still had me listed with CIGNA. The medco rep filled the RX under CIGNA because they did not have me listed as belonging to CR. I called back a few days later to Medco and learned that if they drop the first 3 digits to my CR membership # they could find me in their computer.
The good news is that I got my RX(under CIGNA). It still not clear about the billing. Under CIGNA, my RX costs $15.07 and under CR, the same RX costs $10. I have been told that I have a $5.07 credit on my next RX since they charge my credit card for the RX.   
Then I went on line at MEDCO and it rejected me as not being in the system. I had to call  medco's tech rep to gain access again. These are glitches that Medco/CR should have anticipated, but did not.  
If you are in a similar situation, I would call Medco and determine that they have you in their system as a member with the correct insurance plan. 
upandup  
#14 Posted : Monday, January 23, 2012 12:59:09 AM(UTC)
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It does take Medco's systems a bit of time to recognize changes for individuals. I went from United HealthCare's to GEHA's HDHP (UHC ended the plan due to low enrollment) last year. Both use(d) Medco, but it wasn't until the middle of January that I was able to access the proper information in my online account.
B47  
#15 Posted : Monday, January 23, 2012 6:11:43 AM(UTC)
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deajv1 - my situation with Medco was simply my mis-understanding the information they send me just before the end of 2011. BCBS has switched from Medco to Caremark in 2012 for their mail order prescription service. I mistakenly thought that all FEHB providers used Medco for their mail order service, and I was mistaken in that.

BCBS did switch, but not all FEHB providers did. Medco did tell me that all of my remaining open prescriptions would be honored by Caremark and so far that has been true.

So far ny experience with Caremark has been OK.
dmaceld  
#16 Posted : Monday, February 27, 2012 4:15:06 AM(UTC)
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B47 wrote:
deajv1 - my situation with Medco was simply my mis-understanding the information they send me just before the end of 2011. BCBS has switched from Medco to Caremark in 2012 for their mail order prescription service. I mistakenly thought that all FEHB providers used Medco for their mail order service, and I was mistaken in that.

BCBS did switch, but not all FEHB providers did. Medco did tell me that all of my remaining open prescriptions would be honored by Caremark and so far that has been true.

So far ny experience with Caremark has been OK.

I realize this thread is getting a little bit of age on it, but thought I'd jump in anyway. BCBS has been using Caremark to manage the pharmacy side of the prescription program for several years now. Caremark won the contract for the mail order side also this year and will have it for 3 years. So we'll see what happens for 2015 when it gets here. BCBS had the mail order contract with Caremark several years ago for awhile. I had no problems with them then that I recall.

For those being moved to Medco all in all their service is good. The repeated automated phone calls about your prescription status get old after awhile, but otherwise I had no complaints about their service.



B47  
#17 Posted : Monday, February 27, 2012 7:56:49 AM(UTC)
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Thanks for clearing up the difference between the pharmacy side versus the mail order side of the BCBS program. I have only used the mail order option and as you stated, it was with Medco until last year. As you also state, I haven't seen any change between the two, other that some Web site differences.
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