Hi
I am having a problem with my Federal Blue Cross Blue Shield health insurance. They have Caremark to fill their drug and Caremark could not compound an aspirin. My meds are running two hundred a month for one Rx! They are classifying my Rx medications as a tear 3 drug. It is their stance that because it is a compound medication it is classified as a tear 3. If at least one of the ingredients is not a federal legend the compound drug it is not covered. In one of my prescriptions the vehicle is a federal legend drug a skin cream in which the drug is placed. Now I asked the big question, can a huge corporation like Caremark compound the drug, they could not. It seems that only mom and pop compounding pharmacies can get the necessary ingredients from the Professional Compounding Centers of America. Seems to me that Blue Cross Blue Shield and Caremark are bias to the PCCA resulting is woefully poor service to me the consumer.
If a Licensed Doctor and a Licensed Pharmacist are ok with the compound what gives them the power to deny service and penalize the patient with high co payments? Recently my Doctor contacted them and explained that the much less expensive generic drug upsets my stomach and gives me diarrhea, they still would not put the drug in a lesser category. Presently my co pay is 45% which equated to about $200. A month! Blue Cross Blue Shield has also ended their arbitration. I ask what can be done, who I could complain to. Could I have the RX filled and take them to small claims court? Are there any groups that petition for change?
Thank You
Mickey