Home     Law Advice     Insurance Advice     Community    
Home > Insurance > Complaints > Health > Drug Plans
  Health Insurance Insurance Center
Health Insurance Complaints   Back to Insurance Complaints  
« Back to Health Insurance Complaints Next Complaint »  

Complaint 2 of 4 in "Drug Plans"

Insurance Carrier: HMO Blue
State: Massachusetts

Consumer Complaint:

I have Lupus. I went to fill my Methotrexate today at two pharmacies. HMO Blue denied it saying it had to be a mail order. I was off of Methotrexate for a year but had to go back on. It has always been covered before. The problem is it is a $25 drug out of pocket. That is fine. I need it for tomorrow and I don't have time to wait for a mail order. HMO won't pay for the drug that is sitting in two pharmacies down the street but they will pay for me to go to the doctor every week to get the injection. So now they have to pay for the office visit, the medication, and for someone administer it. It doesn't make sense and it frustrates me. What can I do? I need this medication. I am sick and will be forever. The insurance company should be helping me and others. Any advice on how I can handle this?


Insurance Expert Answer:

Sure. The mail order drug company charges the plan far less than the local pharmacy. So the plan insists on mail order. However most plans allow a local participating pharmacy to fill the first prescription and use mail order for maintenance refills. Also, some mail order pharmacies have next day delivery. And the plan might conclude if you were off it for a year one more day is not life or death.


« Back to Health Insurance Complaints

Next Complaint »  
Satisfaction Survey
Please help us help all of our visitors to make informed buying decisions by taking a few minutes to tell us about your current insurance company. We value your views and experiences and want to make sure we provide helpful information to all of our visitors. We appreciate your participation in this survey.
Find an Insurance Agent
Step 1
Step 2
 
Powered by InsurancePages.com






Step 1
Select Insurance Type
Step 2
 
Featured Articles
Post-claims Underwriting By Blue Cross Of California In Health Insurance May Be Bad Faith


Auto | Homeowners/Renters | Health | Life | Insurance Agents & Quotes | Site Map | Privacy Policy | Media | About Us | Contact Us

FreeAdvice® has been providing millions of consumers with outstanding advice, free, since 1995.
While not a substitute for personal advice from a licensed professional, it is available AS IS, subject to our disclaimer and conditions of use.
FreeAdvice®, AttorneyPages®, ExpertPages®, and LegalSoapbox™ are units or affiliates of Advice Company.
All Rights Reserved © 1995-2009