Those of you who read my last blog post about our aggravating situation with the drug insurance company will find this note of interest, I think.
Friday morning, Robin called the company again and talked with a woman higher up the chain of command. He confronted her about them NOT following their own clear guidelines in their formulary book about notifying their clients 60 days prior to any change in their formulary and also about NOT providing him with a 60-day supply of his medication on Friday, Oct. 16.
The woman told Robin that his drug was not on their formulary, but Robin insisted that it was. “You’ve already filled my prescription two times this year,” he said, “once in March and once in July.”
“I’m sorry, sir,” she said, “but your drug is not listed in our formulary.”
“I know it’s not on your formulary NOW since you withdrew it. But I do know it was on your formulary earlier this year. I received the drugs at the formulary price in March and July, and I have the receipts right here!” Robin’s voice began to rise a bit now from its calm and controlled tone.
“Sir, what I’m telling you is that your drug is NOT listed in our formulary for 2015.”
While Robin was on the phone, I went to our files, pulled out the 2015 formulary book, and searched the alphabetical index at the back. Guess what? She was right! Robin’s drug was NOT on their 2015 formulary list!!! We had no idea, of course, because we’d been getting the drug with no problems. However, it must have gone off their list at the beginning of the year.
So now we have a new mystery. How did it happen that we were able to get the drug at the formulary discount two different times this year? Apparently, that was their mistake! Also, now we wonder what will happen to our request for “an emergency refill” that Robin’s doctor sent to the company?
Robin still has an appointment with his doctor on Tuesday to explore options for transferring from this drug to another one, and he’ll still have to have enough of his current medication to taper off safely. However, Robin did apologize to the drug insurance company rep he talked with.
What a crazy development this has turned out to be!