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Hi all-

Rant #156

Does anybody here work for NMHC Mail? A post from a mail order tech

just may help give me a much needed attitude adjustment. It would put

a face on this colossal mail order entity I have to contend with.

Recently, our health insurance administrator (Zenith) decided to

enforce mail order through this company for maint. meds--or pay out

of pocket at the pharmacy of my choice.

The whole idea just hacks me off to no end!!! I don't mind an

increase in copays. What I do mind is the increase in copays AND

restrictions on where I get refills. No offense Florida, but I would

prefer my scripts be filled in the state that I live in---you know

support my local economy--not Florida's.

I don't take any meds, but my husband does... I briefly thought about

putting the old boy out to pasture, but thought I would try posting

here first.

Thanks for your time,

Dora

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Dear Dora,

I do not know enough about this to comment. But I think this is

illegal unless you have an hmo that is connected to its own clinic

or pharmacy. And example would be Kaiser or the old Maxi Care or

Ross Loos. Am I wrong??

I do hope this works out for you. I know you well and I can see the

steam coming out of your ears! :)

Love ya

Jeanetta

>

> Hi all-

> Rant #156

> Does anybody here work for NMHC Mail? A post from a mail order

tech

> just may help give me a much needed attitude adjustment. It would

put

> a face on this colossal mail order entity I have to contend with.

>

> Recently, our health insurance administrator (Zenith) decided to

> enforce mail order through this company for maint. meds--or pay

out

> of pocket at the pharmacy of my choice.

> The whole idea just hacks me off to no end!!! I don't mind an

> increase in copays. What I do mind is the increase in copays AND

> restrictions on where I get refills. No offense Florida, but I

would

> prefer my scripts be filled in the state that I live in---you know

> support my local economy--not Florida's.

> I don't take any meds, but my husband does... I briefly thought

about

> putting the old boy out to pasture, but thought I would try

posting

> here first.

>

> Thanks for your time,

> Dora

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Hi Jeanetta and Dora,

Not only is this not illegal - it is becoming the trend in keeping costs down

for the insurer. Most companies choose the option which allows up to 3 fills a

year at a retail pharmacy for maintainence meds then the patient must use mail

order. ***Side note to all - read your policy regarding this option. Most

patients don't read the fine print and end up at my step with a drug not covered

rejection for fill #4.*** Anyway, another cost cutting option is allowing

patients to get a 90 day supply of a maintainence med through mail order with a

zero copay or a lesser copay than the customer would be charged if they had the

same drug filled at the retail level for a 30 day supply. Sounds confusing that

way, so let me show an example. A patient can get a 90 day supply of Wellbutrin

XL from mail order for a $5.00 copay or the patient can choose to get the rx

filled at retail for a 30 day supply for a $10.00 copay. The mail order option

is ALWAYS cheaper. Which sounds good to a patient trying to save a few bucks.

But what happens is by cutting out the retail pharmacist the patient doesn't get

the counseling needed. It's almost impossible to call a mail order facility

and speak with someone directly. The patients (often elderly and confused) end

up at a retail pharmacy anyway with lots of questions and unidentified pills

(because the mail order used a different generic than we did) and not that we

mind per se but our pharmacists end up doing the un-reimbursed counseling

anyway. Dora, you are not alone in this - the whole retail industry has been

trying without much success to fight this option.

Good luck,

--

To love what you do and feel that

it matters - how could anything

be more fun? -- Graham

.. . . for my heart rejoiced in

all my labour . . . Ecclesiastes

2:10

-------------- Original message --------------

Dear Dora,

I do not know enough about this to comment. But I think this is

illegal unless you have an hmo that is connected to its own clinic

or pharmacy. And example would be Kaiser or the old Maxi Care or

Ross Loos. Am I wrong??

I do hope this works out for you. I know you well and I can see the

steam coming out of your ears! :)

Love ya

Jeanetta

>

> Hi all-

> Rant #156

> Does anybody here work for NMHC Mail? A post from a mail order

tech

> just may help give me a much needed attitude adjustment. It would

put

> a face on this colossal mail order entity I have to contend with.

>

> Recently, our health insurance administrator (Zenith) decided to

> enforce mail order through this company for maint. meds--or pay

out

> of pocket at the pharmacy of my choice.

> The whole idea just hacks me off to no end!!! I don't mind an

> increase in copays. What I do mind is the increase in copays AND

> restrictions on where I get refills. No offense Florida, but I

would

> prefer my scripts be filled in the state that I live in---you know

> support my local economy--not Florida's.

> I don't take any meds, but my husband does... I briefly thought

about

> putting the old boy out to pasture, but thought I would try

posting

> here first.

>

> Thanks for your time,

> Dora

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Dear ,

Thank you for the explanation and example. Very well presented, I may add.

I can see this from the stand point of saving money for the patient. But it also

adds to the confusion. I think all mail order must require that the drug be

originally filled with inperson counseling from a retail pharmacy first, then it

could be transfered. That of course will never be the law and it would only cut

down on 'some or part' of the problem. But it would help a bit. Also I think

retail pharmacies should also be allowed to offer a maintenece drug for a 3

month / 90 day supply for the min co-pay. Of course this should only be allowed

to be considered a maintence drug if the patient's doctor does not need to see

the pt for another 3 months or so. Any doctor that orders a maintence drug to

a new patient who is put on this drug fro the first time should indicate only

for a specific number of days because it is a new drug or first time Rx for this

specific pt. That again is a type of drug that I believe should not be filled

via mail order. But again these safe guard ideas

will not be implemented because the mail order and the insurance companies will

loose money.

Thanks

Jeanetta

cphtgenius@... wrote:

Hi Jeanetta and Dora,

Not only is this not illegal - it is becoming the trend in keeping costs down

for the insurer. Most companies choose the option which allows up to 3 fills a

year at a retail pharmacy for maintainence meds then the patient must use mail

order. ***Side note to all - read your policy regarding this option. Most

patients don't read the fine print and end up at my step with a drug not covered

rejection for fill #4.*** Anyway, another cost cutting option is allowing

patients to get a 90 day supply of a maintainence med through mail order with a

zero copay or a lesser copay than the customer would be charged if they had the

same drug filled at the retail level for a 30 day supply. Sounds confusing that

way, so let me show an example. A patient can get a 90 day supply of Wellbutrin

XL from mail order for a $5.00 copay or the patient can choose to get the rx

filled at retail for a 30 day supply for a $10.00 copay. The mail order option

is ALWAYS cheaper. Which sounds good to a patient

trying to save a few bucks. But what happens is by cutting out the retail

pharmacist the patient doesn't get the counseling needed. It's almost

impossible to call a mail order facility and speak with someone directly. The

patients (often elderly and confused) end up at a retail pharmacy anyway with

lots of questions and unidentified pills (because the mail order used a

different generic than we did) and not that we mind per se but our pharmacists

end up doing the un-reimbursed counseling anyway. Dora, you are not alone in

this - the whole retail industry has been trying without much success to fight

this option.

Good luck,

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