Conference 7.286::digital

    I was in a similar situation with Harvard Community several years ago,
    when the doctor increased the dosage of my asmatha medication.  I the
    pharmacy's computer kept track of the refills, and it was the druggist
    who told me that a "too soon" refill would be rejected.  I solved the
    problem by asking the doctor to phone in a NEW perscription with
    revised dosage information.  The minor difference was between a REFILL
    and a NEW perscription for the same drug.
    
    Steve

    I too have had a similar experience. My wif and I take the same med. We
    have to keep both perscriptions going evenly or we get rejections.
    
    On this same general subject I got a reject for $13.00 of Meds
    perscribed and furnished by a dentist. I would assume that the
    screening and rejection process must have cost at least $50.00. Perhaps
    there is some clue here to out of control medical costs.
    
    A simple " We will pay X% of ALL med costs regardless... plan would
    probably save money. The only question would be the value of X, and
    that could depend on the employee contribution...

I have a prescription for Retin-A that keeps getting bounced
too - apparently people over either 19 or 25 (depends on which person
I talk to) aren't supposed to have acne.  Each time I refill it
I have to get a letter from my doctor stating that the prescription is 
really being used for acne and not cosmetic purposes.  I then have
to send the letter and the paid bill to John Hancock, they forward
it to PCS, and then about 3 weeks later I get a check.

The first time this happened, last June, they claimed that most of the
prescriptions they were filling for Retin-A were for cosmetic purposes.

M

    Here goes...again.  [sorry, but my John Hancock and PCS experiences
    have been nightmarish]
    
    Just about a month ago, I brought in a NEW prescription to the 
    pharmacy that I had been regularly taking each week's NEW
    prescription.  No refill issue here.  Well, the PCS computer
    link denied the cost with a notice that it was "too soon."
    One of the senior pharmacists said to the junior one, "No, no.
    This is a NEW prescription, not a refill.  Check it again; there
    must have been an error."  So they tried again:  "Too soon" was
    the response again.  I paid about $20 instead of the $6, because
    I *needed* the medicine now.  Each Rx was written for a 1 week
    supply, and I carefully filled them at one week intervals.
    
    I can't make use of the refill strategy, because sometimes I can't
    get to the pharmacy before it closes, so there is a second back-up
    pharmacy where I go instead in that case.  And my main pharmacy
    can't mail me the Rx (and bill me, like they used to do) because
    PCS *requires* my signature when the meds are dispensed.  No, I
    can't sign the book the next time I come in.
    
    Because I take several different medications for several different
    medical conditions, I don't like dealing with lots of different
    pharmacies.  I prefer getting to know the pharmacists, and having
    them know me and my medical situation, so that they, as well as
    I, am alert to possible drug interactions, etc.
    
    Last time I had to get reimbursed for over $100 for meds for one
    of my daughters, it took almost two years, and about 1 dozen
    repeat submissions of copies of the Rx and bill, and about 2 dozen
    phone calls.  My "earnings" per hour were, um, low.
    
    	Pennie

    Actually, there is another prescription alternative to PCS.
    
    Digital has a deal with a company called Express Pharmacy Services in
    Atlanta, where you mail order your prescriptions and get 90 day's worth
    for $2. This is a real good deal if you need medecine for a chronic
    illness. I have had no "early refill" hassles with them.
    
    It takes a while for delivery, so you need to order well before you
    need it. You can get forms from Personnel.
    
    

    re: .5 and the Express Pharmacy Services
    
    I second that suggestion!  They are great, but you do need to
    plan ahead.  Sometimes they are quick, and sometimes they take
    an extra couple of weeks.  At $2 per 3 month supply, it is much
    better for long term meds (even PCS would cost $18 per 3 months,
    and for those of us with several meds, well even that would add
    up).
    
    On my last Express Pharm shipment, they included a slip with the
    $$$value of my meds (do they always do this and I just missed it
    before, or is this new?), and there were 5 different meds (one
    of which the doctor had warned me was VERY expensive)...for $10,
    I received about $300 worth of medicine.
    
    But there are a small number of medications and/or uses that canNOT
    be filled via Express Pharmacy.  Alas.  (Maybe the Retin-A is another
    one of those.)

        I'm suprised at the PCS requirement to sign a book. I have NEVER
        had to sign anything on picking up a PCS prescription. And, yes,
        I have gotten prescriptions this year.
                
                /s/     Bob

    
    	I've had fairly good luck with PCS, but since I have had to
    	move my prescriptions to different pharmacies as I have had
    	to move, I've learned that the individual store's requirements
    	are different.  Some require signeing a book, some require
    	presenting the card, some say,"Nothing to sign.  We know you."
    
    	What does raise a question with me is seeing people from other
    	companies presenting a PCS card and who have their prescriptions
    	filled for $1.00 or $2.00.  Does anyone know if there is an
    	algorithm for these charges or is this strictly a business deal?
    	I'm not complaining -- I'd still prefer paying $12.00/month
    	versus the $100.00+ if I didn't have PCS.  

    >	What does raise a question with me is seeing people from other
    >	companies presenting a PCS card and who have their prescriptions
    >	filled for $1.00 or $2.00.  Does anyone know if there is an
    >	algorithm for these charges or is this strictly a business deal?
    
    It's like any other health benefit.  The amount the employee pays
    depends upon the ability/willingness of the company to pay.
    
    Some companies like American Airlines pay 100% of their pilots medical
    insurance premiums.  Other companies don't have anything like PCS.
    I have a friend who recently changed her insurance from an indemnity
    plan to a managed care plan to get a PCS card that has a $5 co-payment.
    She did this because she and her son are on a medication that has
    proven to be effective for their condition.  They will have to take
    it the rest of their lives.  The bad part is that it costs ~$400/month.
    
    Bob

    I'm having a big problem with PCS also.  I went to get a refill for
    Nicorette gum and the pharmacist got a "no refill" also.  My doctor and
    pharmacist both agree with me that this prescription can be refilled
    sooner than what PCS says.  Apparently PCS has made the decision on how
    soon this prescription can be refilled.  They're going against my
    doctor and pharmacist.  I'd like to know where they get the power to
    make this decision on how soon the prescription can be refilled. 
    grrrrrrrrrr