CVS Caremark PBM

[BSWALKS]

Thanks cynic. Same in NH. Pita & sad yez

 

[BrownBrokeDown]

Mail order works just fine for my son's adhd medication. Do to my doctor, we can only get 30 day supplies, and there was about a 5 day gap between the first prescription and the 2nd, but have had no issues since.

I would not want Costco as the pharmacy for the simple reason that it would be a at least a 2hour drive to fill prescriptions.

 

[upschuck]

So that's a change to the current plan correct? Now I pick up my "maintenance medicine" in 90 day supplies from the pharmacy(CVS). This seems very confusing.

From what I understand, you can still go to CVS for $5 a time, but if you go to another pharmacy, then that is when you pay the higher percentage. I always use Caremark, much easier for maintenance meds.

 

[cynic]

For those with Medco for 90-day supplies the current Rx plan does NOT permit the transferring of your prescription from a local pharmacy to Medco for 90-day fills even if your refill and quantity count would permit it. THis is likely something to look into as we approach January 1, 2014 and TeamCare prescriptions via mail order.

BrokeDownBrown my doc wouldn't give the 90-day Rx for the Adderall either until I had Medco call their office and ask them to justify their reasoning. It was a pain for me to have to pickup a paper Rx that had to be filled within 7 days as well as scheduling an appointment - money mill. 90-day Rx's are permitted by (Texas) state law - something you may want to check into.

Now... how are they going to handle prescriptions for medical marijuana under the new plan?

 

[BrownBrokeDown]

BrokeDownBrown my doc wouldn't give the 90-day Rx for the Adderall either until I had Medco call their office and ask them to justify their reasoning. It was a pain for me to have to pickup a paper Rx that had to be filled within 7 days as well as scheduling an appointment - money mill. 90-day Rx's are permitted by (Texas) state law - something you may want to check into.

Oklahoma allows it as well, however due to my doctors licensing, associations, or something (its been a couple of years since I checked into it and I don't remember exactly what it was at this point), he is unable to write more than a 30 prescription for it. We have the option to change to a doctor that could, but everyone in the family likes him, he is prompt about getting you in and out on time, and always will answer every question you have and doesn't try to candy coat it. The one thing we are actually truly worried about with Teamcare is the possiblility we might have to switch doctors.

 

[BrownChoice]

I dont want to be counting on UPS or FedEx to deliver my lortab each month... If you run out for a single day, you get very sick. I like to be in control and hand carry that prescription to the drug store. To many unknowns and have heard to many bad stories on getting maint. Meds shipped....
besides, for schedule 2 meds you gotta go to dr every 28 days anyways so its actualy not practical to have to send the original copy through the mail then hope to god you receive the meds on time!
there isnt even a cvs pharmacy in my state or the 2 that surround it !

i heard TeamCare uses blue cross blue shield for the medical. Could be aetna as well.. I am worried on the doctor situation as well, i refuse to see anyother!

 

[av8torntn]

If you take a medicine on a regular basis, it's a "maintenance" medication. You'll need to get those through the mail order program..... There's a form you can just give to your doctor and they'll fax it in for you. You won't have to go pick up your medicine anymore, it will be delivered to you.

If you just need a medicine once or twice, like antibiotics when you get sick, you can go to the store and pick them up.

I've been taking a maintenance medication for a few years and just been going to the pharmacy are you saying it will be cheaper or what? I don't really want to fill out forms and be at the house to wait on delivery it seems easier to just go to the pharmacy so I guess I'm just trying to figure out what the advantage is for me to wait on the mail order thing you guys are talking about. TIA

 

[DriveInDriveOut]

The union is in control of the healthcare now. It's in all of our best interest for TeamCare to be paying the least amount possible for medications... even though your copay doesn't change, the cost from store to store does. Mail order prescriptions cost TeamCare less for many reason, one of which is a lower negotiated cost due to the lack of overhead associated with a brick and mortar store. Just like stuff is cheaper online because they don't have to operate an actual store, mail order prescriptions are also cheaper.

I get that the change alone is an inconvenience at first, but it's really not that big of a deal. When you go to the doctor to get the prescription, just take the form with you..... they should fill it out and fax it in to Caremark for you. As long as you don't wait until the last minute for your medicine to run out, waiting on the next 30-90 day supply to get to you shouldn't be an issue.

 

[cynic]

Oklahoma allows it as well, however due to my doctors licensing, associations, or something (its been a couple of years since I checked into it and I don't remember exactly what it was at this point), he is unable to write more than a 30 prescription for it. We have the option to change to a doctor that could, but everyone in the family likes him, he is prompt about getting you in and out on time, and always will answer every question you have and doesn't try to candy coat it. The one thing we are actually truly worried about with Teamcare is the possiblility we might have to switch doctors.[/QUOTE]

I checked the TeamCare site and all the specialists and surgeons I go to are still "in network" so I'm hoping everyone else has a similar experience. I do realize it is early and we're not enrolled in the actually plan but the preliminary research has me less cynical about the coverage.

If the 90-day Rx's are really at no cost for all medications - "brand" or generic based on availability - then this is going to be a HUGE savings for my family. Trying to stay positive as we go into peak and not seeing any seasonals yet...

 

[av8torntn]

The union is in control of the healthcare now. It's in all of our best interest for TeamCare to be paying the least amount possible for medications... even though your copay doesn't change, the cost from store to store does. Mail order prescriptions cost TeamCare less for many reason, one of which is a lower negotiated cost due to the lack of overhead associated with a brick and mortar store. Just like stuff is cheaper online because they don't have to operate an actual store, mail order prescriptions are also cheaper.

I get that the change alone is an inconvenience at first, but it's really not that big of a deal. When you go to the doctor to get the prescription, just take the form with you..... they should fill it out and fax it in to Caremark for you. As long as you don't wait until the last minute for your medicine to run out, waiting on the next 30-90 day supply to get to you shouldn't be an issue.

OK I guess I will still go my my Pharmacy in that case. It's important to me to have a pharmacist that I trust not some unknown, unaccountable entity plus I have the added bonus of the convenience of not doing extra paperwork(the doctor charges $20 to fill out a form), and getting the medicine when needed.

 

[DriveInDriveOut]

OK I guess I will still go my my Pharmacy in that case. It's important to me to have a pharmacist that I trust not some unknown, unaccountable entity plus I have the added bonus of the convenience of not doing extra paperwork(the doctor charges $20 to fill out a form), and getting the medicine when needed.

Lol.... do whatever you want.... if you can afford to pay 50% of the cost of your medicine more power to you brother.
If my doctor charged $20 dollars to fill out a form I would have a pretty interesting conversation with him, that would probably end with me switching doctors. The only places I've seen those form fees are at the nurse practitioner run prescription factories where people go to get the pain pills and prescription speed they don't really need.

 

[av8torntn]

Lol.... do whatever you want.... if you can afford to pay 50% of the cost of your medicine more power to you brother.
If my doctor charged $20 dollars to fill out a form I would have a pretty interesting conversation with him, that would probably end with me switching doctors.

I don't pay 50% now and the letter we got claimed we would pay even less so I'm thinking you may be misunderstanding something.
As far as the cost goes I could probably find cheaper physicians but when it comes to my health I prefer quality over price. With insurance driving down what doctors can charge they get their fees from other sources. It's a very common practice to have fees for paperwork in the more desirable practices.


What it all comes down to is as long as we are both allowed to make our own choices with health care it should all be good right?

 

[DriveInDriveOut]

I don't pay 50% now and the letter we got claimed we would pay even less so I'm thinking you may be misunderstanding something.
As far as the cost goes I could probably find cheaper physicians but when it comes to my health I prefer quality over price. With insurance driving down what doctors can charge they get their fees from other sources. It's a very common practice to have fees for paperwork in the more desirable practices.


What it all comes down to is as long as we are both allowed to make our own choices with health care it should all be good right?

If it's a maintenance medication, after the second refill, you will be charged 50% of the cost if you refuse to get it through the mail order program.....
You're right.... it all comes down to being allowed to make our own choices.....
If you choose to trust a doctor that charges you $20 bucks to fill out a form... thats your choice.

 

[BrownBrokeDown]

Oklahoma allows it as well, however due to my doctors licensing, associations, or something (its been a couple of years since I checked into it and I don't remember exactly what it was at this point), he is unable to write more than a 30 prescription for it. We have the option to change to a doctor that could, but everyone in the family likes him, he is prompt about getting you in and out on time, and always will answer every question you have and doesn't try to candy coat it. The one thing we are actually truly worried about with Teamcare is the possiblility we might have to switch doctors.[/QUOTE]

I checked the TeamCare site and all the specialists and surgeons I go to are still "in network" so I'm hoping everyone else has a similar experience. I do realize it is early and we're not enrolled in the actually plan but the preliminary research has me less cynical about the coverage.

If the 90-day Rx's are really at no cost for all medications - "brand" or generic based on availability - then this is going to be a HUGE savings for my family. Trying to stay positive as we go into peak and not seeing any seasonals yet...

Well, I keep forgetting to ask him his first name. Everywhere I have seen his name, it was C. Mark *****, out of 12 or so *****'s on the Teamcare website there is a Charles *****. So I'm hoping it's just showing his 1st name, lol.

 

[av8torntn]

If it's a maintenance medication, after the second refill, you will be charged 50% of the cost if you refuse to get it through the mail order program.....
You're right.... it all comes down to being allowed to make our own choices.....
If you choose to trust a doctor that charges you $20 bucks to fill out a form... thats your choice.

I've never paid 50% maintenance medication and I've never used some cheap mail order program either. I'm beginning to think that you could be just flat wrong and UPSChuck is correct on this one. About early Jan I'll be refilling my maintenance medication and I suppose that is the only way to know for certain.

 

[DriveInDriveOut]

I've never paid 50% maintenance medication and I've never used some cheap mail order program either. I'm beginning to think that you could be just flat wrong and UPSChuck is correct on this one. About early Jan I'll be refilling my maintenance medication and I suppose that is the only way to know for certain.

Good luck.

 

[BlackCat]

I can't believe how happy you guys are to be be paying 5.00 for prescriptions. Here in the west, we have never paid a dime.

 

[DriveInDriveOut]

CADILLAC health insurance..... and people are complaining that they have to fill out a form and stick it in their mailbox. Their medicine will be delivered to their door for ZERO dollars, no deductible, no copay, ZERO dollars....and they are complaining!!! Freaking amazing.

 

[av8torntn]

CADILLAC health insurance..... and people are complaining that they have to fill out a form and stick it in their mailbox. Their medicine will be delivered to their door for ZERO dollars, no deductible, no copay, ZERO dollars....and they are complaining!!! Freaking amazing.

More amazing is your lack of understanding of the plan you trying to explain to people.

 

[cynic]

More amazing is your lack of understanding of the plan you trying to explain to people.

Have you bothered to take the time to read the TeamCare website? DriveInDriveOut explains things quite well if you have any clue as to what is in the plan. It's in your best interests - for quality and cost - to take the time to do so. BTW, the mail order prescription plan is not a "cheap mail order plan" - it is a cost effective solution that supplies you with the exact same medication you receive at your pharmacy. Think brick&mortar vs. Amazon.

And you will not find out how your maintenance medication costs are in early January - it would take you until February/March until you get charged the 2nd refill at higher cost.