Hello everyone and welcome to 2015! As with every year, the first month is going to be brutal in a pharmacy. Why? Mainly because we have to update your insurance or in worst case– we have to figure out what it is! Secondly, because with a new year comes a new formulary.
What is a formulary? Well those are drugs that your insurance will cover for the the year. However, they are subject to change with little to no notice from your insurance company! For instance, you could be on a medication last year that is no longer covered this year. How does this effect you? It means we need to seek an equivalent alternative and get your doctor to change it over to something that is on your new formulary! An example of these are generic Prilosec (omeprazole) that is no longer covered under certain Express Scripts plans. You will either have to pay it cash or wait until your doctor and the pharmacy can find an alternative. Advair inhalers may be going out of style on certain medicare part D plans. No worries, that just means they want you to change to a new alternative like Symbicort!
How can you help us? Please have the following information available:
1) Your new insurance card if possible. This can be confusing, since there are medical, dental, and pharmacy cards. How do you know which one is your pharmacy? If you have medicare part D plans: your cards should have a six digit number called a “Rx Bin” somewhere. That’s your pharmacy card!
Cal viva, Express Scripts, Medicaid, and Anthem Blue Cross are still the same cards. If you are still on medicaid, we can use the old id numbers to search for your new insurance. This isn’t always the case but usually works 95% of the time.
However, you might encounter a problem in which they haven’t “activated” the pharmacy side of your insurance. This usually occurs when the doctor can run you through, but the pharmacies can’t. Usually waiting 24-72 hours for this can be resolved as it takes the insurance companies time to file the paperwork through.
2) Update your address, telephone number, and email address with us!
Please be patient in the upcoming month as we update everyone! If you see us sweating and stressing out, you now know why. We are trying to get everyone and I mean everyone updated. Then waiting for the doctors to respond to us for equivalent alternatives to your new medication formulary. Most of the inconveniences experienced in the pharmacy will be due to an insurance problem this month and we have no control over what your insurance wants to cover!