I betcha that bcbsnc would be just as furious about what happened today at the pharmacy as Humana is.
I've been posting about my pain medication saga on this blog and my other blog, for the last couple of days now, and had found a pharmacy with the very last of the generic medication in stock, all of the way down in North Port today.
So my friends drove me down to the pharmacy in North Port this afternoon in a massive thunderstorm and heavy rain that lasted the entire drive down there, and half of the way back home, in order for me to get the last remaining stock of the generic Oxycontin HCL 40mg ER, which is Oxycodone HCL 40mg ER.
The pharmacy that I found it at didn't have my full prescription of 90 pills, but they did have 80 of them, close enough.
So I went for it because my doc had said because of that whole mess, that he was not going to write me a new script until he figured out what would work best for me because I am allergic to the equivalent med which is morphine sulfate, (MS Contin) and I am severely allergic to morphine, and also because Fentanyl patches don't work, and the Fentanyl injections are too dangerous and I refused them.
I went into the pharmacy and handed over my script and the pharmacist filled it, ran my insurance for it, and my co-pay was going to be $2.40, and that's when the pharmacist told me that she was losing money because of the insurance.
"What?" I asked.
"Because I am accepting your insurance for this medication," the female Indian pharmacist said, "I am losing money on it."
"What does that mean?" I asked.
"Let me explain. I pay $40 for the medication, Humana is only going to pay me $20 for it, you are only going to pay me $2.40 for it, so I am losing $20.00 by accepting your insurance and giving you this medication" she said.
"Ok, what does that mean for me?" I asked.
"It means that unless you pay me $20.00 for the medication, I cannot let you have this prescription" she said.
"Uh, ok, um, I haven't gotten paid yet, let me go see if I can borrow it from one of my friends" I said, and I went out to the truck to ask Deb and Nic if I could borrow $20 until I got paid Friday night.
Nic let me borrow it but told me I was being yanked.
I said that I knew that and would deal with it later, but right now this was the last pharmacy in the whole damn state with my med, I needed to get it and would report the theft and insurance fraud when I got home.
I went back in and instead of paying the legal amount of $2.40, I paid the theft price of $22.40, got my med, and we drove back home to Sarasota.
What the pharmacist did is called price gouging for one, theft for another, and insurance fraud for a solid third.
It is against the law to accept and charge an insurance company for the medication, actually charge the patient the real co-pay amount, and ask the patient to pay another price on top of that.
I know by going to the Humana website and logging in to my account, that I can see how much the medicine costs, my co-pay amount, and how much Humana pays the pharmacy when they submit the claim to Humana.
The medication costs $670.62, my co-pay is $2.40, and then Humana pays the pharmacy $668.22.
That is actually what it says on the My Humana page for today's (Friday October 16th, 2009) prescription fill at the pharmacy I went to today.
At my usual pharmacy that I had been getting it at for a full year before this whole Purdue lawsuit mess, the price of the med was $789.95, because they were getting the generic version from a different pharmaceutical company than the one I got today.
My regular pharmacy was getting them from Watson Pharmaceutical, and they were round and orange-ish-yellow.
Today's pills were manufactured by Dava Pharmaceutical, the pills are round and purple.
The different pharmaceutical companies all make their pills look different, and they charge different prices for them.
But that's really neither here nor there, what this pharmacy did was illegal.
And she knew it too.
It is an independently owned pharmacy, the husband and wife own it together, she's the pharmacist, he's the cashier, 1 cash register, 1 tiny little store.
She so totally knew that what she was doing was illegal, and she took steps to prevent being caught.
On the patient medication print-outs, there is always a strip at the top that says the name, address, and phone number of the pharmacy, it says the medication name, how much it costs, and how much the co-pay is.
This little strip is perforated to be torn off for the patients use.
The pharmacist tore it off so that I wouldn't have access to the truth.
She made 1 mistake though, she let me keep my cash register receipt that clearly says that I paid $22.40 for 1 prescription, and the receipt has the name, address, phone number, and the name of the pharmacist right at the top.
When I got home, I immediately called my insurance company to report what had happened.
The Humana rep was aghast at what I was telling her, she placed me on hold while she got a supervisor and asked what she was supposed to do for this kind of thing, and then she told me that they had all of the pharmacy's information in the system already because the pharmacist had submitted the claim, I really did pay the legal co-pay amount of $2.40, and she told me that they were sending me a form to fill out, that I would need to photocopy all of the paper work that I did have, like the receipt and the patient print out showing that she tore the patient use information strip off, and that I would need to explain exactly what happened, what the pharmacist told me, and then she told me that I needed to report it to my state's price gouging hot-line, and the police in North Port, which I did.
I left a voice mail for the hot-line in Tallahassee because that's what you're supposed to do, and I spoke to a detective at the North Port police department who told me that I would need to go back to NP and file a report and bring the evidence and my witnesses with me.
Both Deb and Nic said that they would be happy to go to NP with me and fill out the report, especially Nic because she's the one who loaned me the $20.00 to pay for it, and was just as shocked as I was that the pharmacist did that.
All 3 of us were in shock that she ripped me off for $20.00 when she had submitted the claim to Humana for the full price of $668.22, claiming that she was going to lose $20.00 by accepting my insurance.
Can you freaking believe the week I have had just trying to get my freaking medication?!?
Totally unreal right?
I mean, who the hell else would have this kind of luck?
This is the kind of stuff that happens to me all. of. the. time, and this pharmacist knew that she was the last pharmacy to have the medication, she knew that I had to have it, so she totally took advantage of those facts and she stole $20.00 from me, lied to me, submitted the claim to the insurance, so that's fraud, and she totally, illegally, price-gouged me!!
Seriously people, this kind of crap only happens to me.
Because I don't want any other person in the south west Florida area to be ripped off, I am telling everyone right here on my blog, to never, ever, go to D & A Pharmacy in North Port Florida, located at 3015 Bobcat Village Center Rd. in the Bobcat Village Shopping Plaza.
This is a picture of their store front happily provided by the pharmacy to be listed on Google.
Never go there folks.
Ever.
====================
I've been posting about my pain medication saga on this blog and my other blog, for the last couple of days now, and had found a pharmacy with the very last of the generic medication in stock, all of the way down in North Port today.
So my friends drove me down to the pharmacy in North Port this afternoon in a massive thunderstorm and heavy rain that lasted the entire drive down there, and half of the way back home, in order for me to get the last remaining stock of the generic Oxycontin HCL 40mg ER, which is Oxycodone HCL 40mg ER.
The pharmacy that I found it at didn't have my full prescription of 90 pills, but they did have 80 of them, close enough.
So I went for it because my doc had said because of that whole mess, that he was not going to write me a new script until he figured out what would work best for me because I am allergic to the equivalent med which is morphine sulfate, (MS Contin) and I am severely allergic to morphine, and also because Fentanyl patches don't work, and the Fentanyl injections are too dangerous and I refused them.
I went into the pharmacy and handed over my script and the pharmacist filled it, ran my insurance for it, and my co-pay was going to be $2.40, and that's when the pharmacist told me that she was losing money because of the insurance.
"What?" I asked.
"Because I am accepting your insurance for this medication," the female Indian pharmacist said, "I am losing money on it."
"What does that mean?" I asked.
"Let me explain. I pay $40 for the medication, Humana is only going to pay me $20 for it, you are only going to pay me $2.40 for it, so I am losing $20.00 by accepting your insurance and giving you this medication" she said.
"Ok, what does that mean for me?" I asked.
"It means that unless you pay me $20.00 for the medication, I cannot let you have this prescription" she said.
"Uh, ok, um, I haven't gotten paid yet, let me go see if I can borrow it from one of my friends" I said, and I went out to the truck to ask Deb and Nic if I could borrow $20 until I got paid Friday night.
Nic let me borrow it but told me I was being yanked.
I said that I knew that and would deal with it later, but right now this was the last pharmacy in the whole damn state with my med, I needed to get it and would report the theft and insurance fraud when I got home.
I went back in and instead of paying the legal amount of $2.40, I paid the theft price of $22.40, got my med, and we drove back home to Sarasota.
What the pharmacist did is called price gouging for one, theft for another, and insurance fraud for a solid third.
It is against the law to accept and charge an insurance company for the medication, actually charge the patient the real co-pay amount, and ask the patient to pay another price on top of that.
I know by going to the Humana website and logging in to my account, that I can see how much the medicine costs, my co-pay amount, and how much Humana pays the pharmacy when they submit the claim to Humana.
The medication costs $670.62, my co-pay is $2.40, and then Humana pays the pharmacy $668.22.
That is actually what it says on the My Humana page for today's (Friday October 16th, 2009) prescription fill at the pharmacy I went to today.
At my usual pharmacy that I had been getting it at for a full year before this whole Purdue lawsuit mess, the price of the med was $789.95, because they were getting the generic version from a different pharmaceutical company than the one I got today.
My regular pharmacy was getting them from Watson Pharmaceutical, and they were round and orange-ish-yellow.
Today's pills were manufactured by Dava Pharmaceutical, the pills are round and purple.
The different pharmaceutical companies all make their pills look different, and they charge different prices for them.
But that's really neither here nor there, what this pharmacy did was illegal.
And she knew it too.
It is an independently owned pharmacy, the husband and wife own it together, she's the pharmacist, he's the cashier, 1 cash register, 1 tiny little store.
She so totally knew that what she was doing was illegal, and she took steps to prevent being caught.
On the patient medication print-outs, there is always a strip at the top that says the name, address, and phone number of the pharmacy, it says the medication name, how much it costs, and how much the co-pay is.
This little strip is perforated to be torn off for the patients use.
The pharmacist tore it off so that I wouldn't have access to the truth.
She made 1 mistake though, she let me keep my cash register receipt that clearly says that I paid $22.40 for 1 prescription, and the receipt has the name, address, phone number, and the name of the pharmacist right at the top.
When I got home, I immediately called my insurance company to report what had happened.
The Humana rep was aghast at what I was telling her, she placed me on hold while she got a supervisor and asked what she was supposed to do for this kind of thing, and then she told me that they had all of the pharmacy's information in the system already because the pharmacist had submitted the claim, I really did pay the legal co-pay amount of $2.40, and she told me that they were sending me a form to fill out, that I would need to photocopy all of the paper work that I did have, like the receipt and the patient print out showing that she tore the patient use information strip off, and that I would need to explain exactly what happened, what the pharmacist told me, and then she told me that I needed to report it to my state's price gouging hot-line, and the police in North Port, which I did.
I left a voice mail for the hot-line in Tallahassee because that's what you're supposed to do, and I spoke to a detective at the North Port police department who told me that I would need to go back to NP and file a report and bring the evidence and my witnesses with me.
Both Deb and Nic said that they would be happy to go to NP with me and fill out the report, especially Nic because she's the one who loaned me the $20.00 to pay for it, and was just as shocked as I was that the pharmacist did that.
All 3 of us were in shock that she ripped me off for $20.00 when she had submitted the claim to Humana for the full price of $668.22, claiming that she was going to lose $20.00 by accepting my insurance.
Can you freaking believe the week I have had just trying to get my freaking medication?!?
Totally unreal right?
I mean, who the hell else would have this kind of luck?
This is the kind of stuff that happens to me all. of. the. time, and this pharmacist knew that she was the last pharmacy to have the medication, she knew that I had to have it, so she totally took advantage of those facts and she stole $20.00 from me, lied to me, submitted the claim to the insurance, so that's fraud, and she totally, illegally, price-gouged me!!
Seriously people, this kind of crap only happens to me.
Because I don't want any other person in the south west Florida area to be ripped off, I am telling everyone right here on my blog, to never, ever, go to D & A Pharmacy in North Port Florida, located at 3015 Bobcat Village Center Rd. in the Bobcat Village Shopping Plaza.
This is a picture of their store front happily provided by the pharmacy to be listed on Google.
Never go there folks.
Ever.
I am just sitting here w/ my mouth open. I mean, you know I've had my fair share of medical hell through the years so I'm not surprised - it's just. Wow. I'm so sorry you're having to go through all that. I had a generic I could only take one form of and it was really an nightmare - and that was just for sleep. Pain? Entirely different hostage-situation altogether. Hang in there and thanks for standing up for those who can't!
One: I cannot beleive all the shit you have to deal with. If ANYONE deserves a freaking break, it's YOU.
OMG
two: I strongly suggest that you go and edit this post, instead of titleing it " i was scammed by the pharmacy" change it to I was scammed by D&A pharmacy" that way you have a better chance of being a top google search if someone searches that pharmacy.
People should know this happened.
Whoa. I had something similar happen with my former dentist.
My dental insurance allowed for us to pay a lower rate for certain things outside routine cleaning and such. Well, I had to have a root canal and crown a few years ago. When it came time to pay, the dentist's wife, who ran the desk and books, told me how much (300.00 more than what I knew it was suppose to cost- I had already talked to my insurance company and knew what I was supposed to pay) I explained to her that by accepting my insurance, I paid the member price not their regular price. The woman fought with me tooth and nail, saying it would ridiculous for them to do that, that they'd be losing money, blah blah blah.
So I said, "whatever, send me a bill" then got home and called my insurance company. Sure enough, I was right and filed a complaint. The insurance company sent ME a check for the hassle of having to deal with them, and the dentist continued to send me a bill for the full price, not the insurance member price for over a year. I'm fairly certain the insurance company yanked them, and I have since switched.
Ugh. Greed!
Wow, that is just RIDICULOUS. The things people will do. I'm glad that you went straight home and reported them!
I didn't know you had this blog as well, and lost my feed to the other one when my email program decided they wanted to charge me so I was out of the loop. I'm just flabbergasted on various counts that there's been such a med saga going on.
I had no idea that such a thing happened with meds, or what the procedures or rights were so I'm thankful to read the information. I'm trying to find various different places to get my various medications so I can actually afford them, and would have had no idea what to do in that sort of situation, so thank you for spreading the word in that regard, but I'm sorry you had to go through yet another craptastic thing. I hope things improve soon.
That is really messed up. The greed of people to go after someone that is trying to get the meds that they need and basically holding it hostage. It is so many levels wrong. Any amount is bad, but for twenty dollars! I'm surprised they didn't try for more. I'm glad that you were able to get the medication that you needed, but sorry that you had to go through all of this to get it.
I am on my way out to run errands, but I have a HUGE email brewing for you in regards to this.
In the meantime Kat, a lot of the reason no one has your meds is due to all of the pain management clinics dealing out to addicts. (Apprarently, those in Broward County...)
Go see my blog Kat, my latest post..and watch what I posted the link to. I'd be willing to bet my lungs it will outrage you as much as it did me.
I am sorry you have to deal with such BS...
Disgusting. This woman needs to have her pharmacist license revoked, and she and her husband need to be prosecuted. Who knows how many other people they've done this to?
I would also go to the media about this; call the local newspapers and TV news departments. I bet they'd love to do a story on this sort of thing.
I saw your tweet and re-tweeted it, will blog it later, after we get back from doing stuff.
What a shitty thing to do! I am so glad you know your stuff and were actually able to report her. If that had been me, I wouldn't have known that I was being ripped off let alone that the pharmacist was price-gouging and defrauding the insurance company.