Our oldest son Joey is on several medications. Unfortunately, several are highly-controlled medications. In addition, as a former ward of the state, he's on Medicaid. Many of you already know where this is going.
Thanks to obnoxious Medicaid rules -- which were created thanks to people who abuse the system plus a healthy dose of bureaucratic quackery -- acquiring some of Joey's medications is a royal pain in the butt. We jump through all sorts of hoops on a regular basis. The prescriptions have to be hand-written by the doctor (no electronic or phone-in prescriptions). Refills are limited. Prescription renewals require a visit to the doctor. We can't order the next batch of medicine before a certain time, despite knowing when we're going to run out. We're treated like drug dealers if we lose a pill. And so on. It all makes for a wonderful case study on inefficiencies and absurdities in America's health care industry.
But let's not delve into that mess. Instead, I want to focus on the awesome folks at Hy-Vee's pharmacy. (Specifically the Williamsburg location.) We're currently involved in a situation where Joey is out of a med. We can't just go in and get a refill because apparently a generic is now available and Medicaid requires the use of generics if they exist. No big deal, right? Except Hy-Vee can't give us the generic because their supplier is giving them the run-around and being slow, so Hy-Vee doesn't have the generic to give us. That leaves us in a pickle. We're out of an extremely important pill, Joey's health (and our sanity) is at risk, and Medicaid won't bend to make a temporary exception to help us out.
Fortunately the folks at Hy-Vee stepped up. They've given us some of the name brand pills to hold us over until an alternate supplier can provide the generic equivalent. That means Hy-Vee is eating the relatively substantial difference between the cost of the pills and the amount that Medicaid will actually reimburse.
In the grand scheme of things the financial impact on Hy-Vee is virtually nil. But the value to us is significantly higher than that. In addition, the direct financial impact doesn't include all of the time and energy put in by the staff at the pharmacy in trying to resolve this. (Phone calls. So, so many phone calls.) Furthermore, this isn't the first, second, or even third time that pharmacy staff have gone out of their way to help us. Joey's situation is extremely complicated, and without an excellent pharmacy to help us over the past 20+ months, there no doubt would have been many more headaches and hurdles.
I don't know what the service is like at other pharmacies around town, but no way will you see us leaving Hy-Vee any time soon. We are grateful for their help.
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We pharmacy at the Williamsburg Hy-Vee, even though Walgreen’s, Super Saver and CVS all are closer. Williamsburg Hy-Vee pharmacy awesome, but then we think Hy-Vee is just awesome in general. Plus, I went to college with one of the pharmacists there.
I just wanted to clarify something. This is not an issue with Medicaid. You would be going through the same hoops even if you were using Blue Cross (which is what we have). Our daughter was diagnosed with ADD Inattentive. While on the medication they gave her, we went through the same hoops as you. There is a huge racket with all of it as well. My daughter’s therapist couldn’t write scripts (most can’t) so she would have to see a 2nd doctor to get the script, with us being charged for both doctors (around $150 per dr.). I would have to drive from Arnold Heights to 84th and O each month to get the script/dr. visit. At one point there was a shortage of the medication and we had to call pharmacy after pharmacy to find some place that had it. So I do empathize.
Have you tried going to other pharmacies (non-grocery stores specifically) and see if they have the medication?
I go to a family owned pharmacy here in Lincoln and they do a great job at giving me the medication whenever I need it. I would highly suggest checking out Four Star Drug.
True, not every problem I mentioned is Medicaid-specific. Some are, of course, but others are endemic to insurance in general, or they’re created by federal law, or whatever.
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