<p>Thank you, all! Especially Parentof2014grad. That is good advice! Thing is, I wish I could just go to the pharmacy but it would cost us hundreds of dollars because our insurance won’t cover long term meds through the local pharmacy, only through the mail order. We used to have MEDCO and they were fine. It was a pain to get the prescriptions to them but they never messed up like Express Scripts. I looked Express Scripts up on the Better Business Bureau and on Consumer Reports and WO!!! People are not feeling the love. Diabetics going without insulin die to red tape and slip ups, etc. </p>
<p>I just sent a lengthy email to the CEO of the company. We’ll see if I get a response.</p>
<p>My H is on Medicare with Tricare (retired military) as his supplement. We have received notice that “some” of his medicines (chronic lung disease, afib. ADHD, and a few other ailments) must be done by mail order, Express Scripts. After 2 refills at the local pharmacy, they will not pay. I registered him online and could find only his inhaler on the list, so I called their customer service number. As of right now, only the inhaler must be done mail order; the rest are all generic and can be done locally. After hearing all of your nightmare experiences, I am really grateful. I hope that I was given the correct information because I really don’t think that I can fight the federal government and win.</p>
<p>Lotsofquests, that’s interesting. Tricare and Express Scripts are part of the same group I believe. Some of our meds are generic also and I will check into whether we need to get them through the mail. My assumption was that we did but I will ask H to stop by his HR and get details. We don’t have a Costco anywhere near us so I can’t explore that option. In the meantime I will diligently pursue my complaint.</p>
<p>If that CEO or the company has twitter…I understand many vendors respond very quickly when tweets are critical!</p>
<p>We had Express Scripts when we had Anthem. When they changed their phone protocol, I stopped using them.</p>
<p>In my case, I DID hand carry the script to the pharmacy. But apparently, even though I had multiple refills left on my previous script, the pharmacy used the newer one. I need to get a refill script every six months…for a maintenance med. My doc has me on a TWO year recall. So…this fax/phone/fax/phone crap happens every six months without fail.</p>
<p>Our insurance company REQUIRES us to get any medicines we are on for long term through the mail. If we don’t, we have to pay full price at the pharmacy. Which, for some things, I suppose, if you can use a generic, isn’t a big deal, but for others it’s a very big deal. A friend just turned me onto a website called goodrxDOTcom. You plug in your zipcode and the name of the medication, and it shows you the prices at local pharmacies so you can compare. Sometimes it’s just worth paying out of pocket! </p>
<p>By the way, my experience, both on the patient and treating professional side is that when you complain to your employer, you need to complain to HR, not to the benefits department. Benefits just contracts with the RX company and is likely more cost driven… They don’t seem to care as much about the impact on the employee or to be effective in getting a personal problem with an insurer resolved. They might tell you about the process of who to call, but they wont likely help resolve the problem. HR though should be more involved in and concerned about the employee, and can also deal with benefits if they need to. Especially if the employer is self funded and merely contracts with an insurance company, HR can seem to shake things loose when you feel stuck.</p>
<p>Also, I agree hat a complaint to the insurance commissioner can be helpful. Writing the Consumer protection agency and federal trade commission is good too, but I cant wait to hear the response from the company president. That should be effective. If you have any friends in journalism, complaining to the media or using one of those tv station “help” guys may be a good idea too.</p>
<p>The scenario you describe is outrageous. Hope you can get it resolved soon.</p>
<p>On another note, I’ve had an issue with some dermatology lab that engages in egregiously smarmy erroneous billing practices- sends bills for old (as in several years old, on my son) supposed services with no supporting documentation for the disputed claims despite multiple calls, letters, etc. to them to try to resolve it. Wont hijack this thread, but suffice it to say that attempting to reach the provider, billing staff and complaining to BBB (who has many, many complaints about this lab’s billing practices on file and rates them an “F”) has done nothing. Sending proof that this was resolved 3 years ago, including copies of their paid bills, and a check for “complete and final payment” which was cashed by them only seems to have let them know they have a valid address and they send more bills and to a collection agency!! Next will be a complaint to the FDCPA, FTC and Board of medical examiners, since the Dr wont return calls and allows this egregious billing to continue. If my credit gets dinged, the dr is doing harm, which is against the hippocratic oath. </p>
<p>What parentof2014grad said. I had (a lot) of trouble with Medco, and filed a complaint with the state board of pharmacy in Ohio (where the prescription was sent, not where I live) and within five days got a phone call from a very upset Medco manager wanting to know what they could do to resolve this problem so that I could let the state board know it had been handled. It got fixed very quickly.</p>
<p>Now that we have a high deductible plan there’s no pricing advantage to using the mail order pharmacy unless/until we meet the deductible, so I just use my really nice local pharmacy and avoid all the hassle. </p>
<p>I’m of the take-no-prisoners approach to health insurance companies and their evil spawn. They get two chances to fix a problem, and that’s it. The state insurance commissioner’s office has (and uses) an electric cattle prod with the insurance companies, and the various state pharmacy boards seem to have a similar prod for recalcitrant mail order pharmacies. </p>
<p>If you want to see 4300 other stories like mine about them, go to the Better Business Bureau site. It is shameful.</p>
<p>My D called her doc today to have them call in the script to the local walgreens. I will have to pay full price out of pocket but plan to bill it to Express Scripts. I’m taking this on like a part time job. Hope they’re ready for me.</p>
<p>EPTR, insurance companies and their evil spawn, to quote arabrab, are immune to shame. All they care about is money, and I would bet you they are highly profitable. Part of their profit is due to the severe understaffing which leads to situations like yours, situations which could be prevented or easily handled if they had more people.</p>
<p>I found the CEO on Twitter and found Express SCripts on Facebook. The facebook page is filled with posts from unhappy customers. i posted to it saying that I hoped the CEO had a minute to check his email and that i would be filing formal complaints against the company. They responded twice to my post. Want me to send them my ID number etc so they can look into it. They can kiss my you know what.</p>
<p>I will be lodging a complaint with my husband’s company in HR and with the insurance commission, BBB and Consumer alerts. </p>
<p>with a formal procedure for complaining to ES and complaining about them to the “Defense Health Agency
Pharmaceutical Operations Directorate”. You might want to do both of these, letting ES know that you have also complained to the gov’t.</p>
<p>I read the first few complaints on this website:</p>
<p>It’s shocking that this company is still in business. My problem, that caused me to stop using them after the first time, is nothing compared to what these people experienced. I experienced aggravation, some of these people’s lives were put in danger. And, in at least one case, a large shipment of a controlled medication with a high street value was lost.</p>
<p>I have not had any problems yet with ES but I was concerned when I thought we were being forced to do mail order. My one experience with the phone customer service was very positive. Because most of my H’s prescriptions are generic or controlled substances, we can still use our local pharmacy. His first mail order arrived today, just when they said it would. I will keep my fingers crossed and bookmark this thread in case we have any problems in the future. So far, I have not checked my records to see what I will be forced to do by mail.</p>
<p>ES couldn’t care less about negative customer reviews. They only have to keep two parties happy – the insurance company (which adores ES for cutting their costs) and the regulators. So those are the parties to complain to. </p>
<p>If this is a marketplace plan, under ACA you have the right to change carriers for next year. So you could tell the insurer that if you’re not offered a better option, that’s exactly what you’ll do. If it’s an employer plan, you should definitely complain to your employer, and try to get your fellow employees to do the same. </p>
<p>I detest ES. We had Medco until this year … I think the two merged? My pharmacy cost has more than doubled for my thyroid … but I can get it through mail order from ES for the lower price I used to pay. When I try to sign in to ES to set up my account so I can transfer it to mail order, they say I don’t exist … I can see that I exist in my H’s online account, but I don’t exist enough to set up my own online account (and of course, I can’t order through his account). Guess I have to call, but what a pain. </p>
<p>If your insurance is through an employer, try complaining to the HR department, as well. At H’s company, this won’t work … it’s too big, and they don’t really care. But I was a group benefit consultant for awhile, and I worked with a number of HR departments that cared very much about this sort of thing. They would go head to head with ES over this sort of thing, and they would move their business if things like this kept happening. There are many companies who truly care about their employee’s benefits, and they will want to know.</p>