I called in a refill for my prescription from the bariatric clinic yesterday afternoon.
This morning I was contacted by the clinic.
The nurse explained that she can only approve enough additional medicine to take me up
to the date of our next appointment. She added that I’d have to pay full price for the
medication, even though I’m receiving only a fraction of the 30-day prescription.
After some discussion, I learned that the reason I’m now in this position is because
the clinic scheduled my upcoming appointment more than 30 days after my last one. In other
words, the clinic just jacked the price of my medication up 300% because they pushed my
appointment out.
It’s important to note that the clinic had just prescribed me a scheduled substance
which cannot be prescribed for more than 30 days at a time, and knew that my insurance
plan refuses to pay for the medication. The medicine was described by the clinician as
the medicine they prescribe most. I feel like there’s no way they couldn’t have known
that scheduling my follow-up appointment so far out wouldn’t have these ramifications.
The clinic should have anticipated the impact of scheduling my follow-up greater than
30 days out and made some arrangement to account for the gap without impact to me. Instead,
they have forced me to decide between paying an exorbitant amount for the medication to
cover the gap, or going without the medication.
I’ve contacted the patient advocate and explained my view. The advocate was going to
discuss things with the clinic. What I really want is some arrangement by which I will not
be financially accountable for the additional medicine required to get me to the next
appointment. There’s probably not much chance of that happening. But at least I’ve made
the advocate aware that I’m also likely not the only one this will happen to.
A few hours later, I heard back from the patient advocate. In short, I was told there
was nothing they could do for me. I suggested the advocate consider talking with the
clinic and ascertaining how many people were scheduled for follow-ups in excess of 30 days
to determine how big of a problem this really is. Meanwhile, the advocate weakly suggested
the my pharmacist may not charge me the full sum, given the quantity of medication I'm
due to receive. We'll see.
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