In brief, my 22 yr old son is covered under d/h's company insurance plan, Blue Shield PA. He went to drugstore to pick up meds he needs as he is leaving town for a week early Sunday, and they could not verify coverage. I called the "member contact" number on our card, and the automated system did not have him listed. The rest of us still are, and there is no reason he should have been omitted.

The system tells me CS reps will be available Monday. That is too stinking late. I wondered if anyone has any ideas how to access CS off-hours. I know this is a creative bunch!

And no, we cannot just pay it & seek reimbursement as it is very expensive stuff. I am so incredibly frustrated.

TIA for any suggestions.

Are you sure he's covered? Most kids drop off after 21 or 22.

__________________
bite me and get a brain!

Some pharmacies allow for a partial fill of meds--you might try and see if the pharmacy would give a week "emergency" fill. If they will, then it should be far less expensive than a full month.

I have to assume that none of the meds he's needing is on the $4 list? Are the meds filled as name brand or generic? If they are name brand, is there a reason why they can't fill them as generic?

If these meds are maintenance meds, in the future it would probably be easier if he did them mail order and got 3 months at a time---doesn't help you now, I know.

__________________
Mental that one, I'm telling you. ---Ron Weasley, "Harry Potter and the Chamber of Secrets"

Hon so sorry to hear this , its so frustrating when you need your meds and cannot obtain them. Can I ask hon as your ds gotten his medication from the same pharmacy.I ask this because we all as a family get our medication from cvs and all our information is in their computer system. Also is there anyway you ds can go back to the doctor who prescribed the medication and perhaps he or she can offer your ds some samples of the medicine. Sometimes they have samples of the medication right there is their office a few samples to hold your ds over till this problems gets cleared up. Finally perhaps someone here on the boards may offer better helpful information. Either way hon I am so sorry and sincerely hope all works out for you and your ds keep us posted. Peace. Catherine

Thanks for the responses. He is covered until he graduates. No question about that. It is clearly an error. (And not even close to the first PIA mistake they've made.) He does get a generic of one, and the other is relatively new & there is no generic yet. None are on the $4 list, and the doctor's office will not reopen until Monday. He is in the pharmacy's system, but it automatically confirms coverage with each script & the computer is rejecting it.

I will contact the pharmacy & see if they will give him a partial fill. That's a really helpful suggestion, so thank you.

%$#@$^! insurance companies.

Is he trying to refill too soon?? I know on ours, it will kick it out if you try to refill the Rx too soon.

I would call the doctor's answering service, and ask them to have him call you. Maybe he has samples or something he can give your DS.

__________________
Doing the right thing isn't always the same as doing the easy thing.

Does he have enough meds to get him through Monday? Once you get everything straightened out with the insurance he could have the prescriptions transferred to a pharmacy where he is and have it filled there and then when he gets back next month transfer it back home... I have had to do that before it worked without a problem with all medications except for the controlled ones.

__________________
~ Christine ~
Grammie to Trinity Lorayne Jean Keens Born June 9, 2011 Loving my awesome guitar picking 100% Country Boy boyfriend Kenny !
RIP Daddy~ 01/24/1930-06/01/2007 I miss you !
Dont Think you Can .. know you can ~ Jeff Hardy

I truly feel for you with all of the frustration. My oldest DH is 24 and in his 6th year of college. About twice a year for the last 6 years we will randomly get an EOB from BC/BS saying that he isn't on the plan. I must then make numerous phone calls and remail the proof of enrollment from the university website. It sure is odd that this continues to happen.

The goal of insurance companies is to pay the least amount of money and take the longest amount of time to do it. Grrrrrrrr........

I believe that most people just pay out of pocket instead of being persistant with the customer service folks on the phone.

Good Luck to you.

You should be able to get someone from the insurance company even on weekends, etc. Call the part that handles just meds.

Pay out of pocket and then have them reimburse you.

I agree with the partial filling and also paying out of pocket and getting reimbursed if he really needs the meds. I work in a chain pharm and this happens a lot unfortunately. Unfortunately most of the pharmacy helpdesks can only confirm that coverages have expired and/or sometimes give you the date that coverage expired if you get a rep that is helpful. The customer service part that you have to call to get him back in the system is the only way I know of to get through. If you do have to pay out of pocket, just save your rx receipts and if the pharmacy is willing to and able to retrobill it within a certain amount of time, then you can get your money back at the pharmacy usually and not wait on a check from insurance.

Hmmmmm just how many dh's do you have? I think one is more then enough. LOL

My guess is that the insurance company is wanting verificiation that your DS is still a full-time student.

I had something similar happen to my 5 year old when I took him for his well visit earlier this year. He has been very healthy and did not have any 'sick visits' since his last 'well visit'. The insurance company was convinced that he must be covered under another plan because 'no 5 year old goes a whole year without a sick visit' -- that is what they told me. Well, guess what, mine did and so did his 8 year old brother (which they didn't question). I went round and round with them and finally they accepted it.

Ask the pharmacy for a 'partial fill' of the perscription to get your DS through until you can get it straightened out with the insurance.