Epinephrine vs. CVS Caremark

For the last ten days, I have been trying to get medications for my next round of treatment from my god-awfully incompetent prescription insurance and their specialty and mail order pharmacies. Let me tell you, in the five months since I last dealt with CVS Caremark, they haven’t improved. Here are some highlights:

My doctor faxed the prescription. Two of the medications need prior authorization, the other two don’t. Thus, two come from CVS Caremark’s specialty pharmacy while the other two come from their mail order pharmacy. The two pharmacies do not talk to each other. Separate on-line systems with separate patient log-in information. Separate call centers. Neither pharmacy has any idea what the other one is doing or knows. Thus, I have to place twice the calls when nothing at all happens with both sets of meds.

Call 1 – CVS Specialty. They confirm that they have the order and even have the prior authorization info from my doctor, but are waiting on insurance information.

Call 2 – CVS Specialty. They inform me that my insurance has denied the claim. This is odd, because I should have just enough coverage left for this order, and then I’ll be out. I ask for more details. The call center agent tells me that my Aetna PPO has denied the claim. I tell him I have never had an Aetna PPO, I have CVS Caremark insurance. He tells me that the claim was submitted to Jennifer Haines’ Aetna PPO plan. I have already told him my name, it is not Jennifer Haines. I reconfirm this with him. Despite this, he proceeds to read off Jennifer’s plan number to me. Awesome. I reiterate, for at least the 5th time, that it isn’t my information. He gets the correct info entered (in theory) and says they’ll submit to my insurance next.

Call 3 – CVS Mail Order. They have my prescriptions, but need information from my doctor. No, wait, they already have the information from my doctor. The prescriptions should ship soon.

Call 4 – CVS Specialty. They inform me that insurance has approved the claim, but I can not yet order the medications because, “they’re not in the system yet.” What the fuck does that mean? The call center rep can’t explain.

Call 5 – CVS Mail Order. Still not in the system. Should be in the system in the next day or two and will ship then. Sorry for the delay, don’t know why it’s happening.

Call 6 – CVS Specialty. Still not in the system. Try calling again tomorrow.

Call 7 – CVS Mail Order. Not in the system. Wait, yes, they are in the system. But, unsure if pharmacy has enough in stock to meet the order. What in the fuck? This is a mail order pharmacy and these are common drugs. Also, I communicate that I’m concerned about the prometrium, because it’s a gel capsule and our temperatures are supposed to hit -22F. I’m worried it will freeze in transit and be destroyed. They transfer me to a pharmacy tech, who can’t tell me anything, but transfers me to a pharmacist. He agrees that it will probably be an issue, but “we can’t do anything about it.” I can either pay for expedited shipping or wait for the meds to arrive and file a claim if they’re ruined. There’s customer service for you.

Call 8 – CVS Specialty. In the system! Ordered! Shipped! Shipped without telling me, and by the way, adult signature is required, so now I have to make last minute arrangements to work from home so I can get the package.

While in the hospital, I lost enough blood that no one could find my blood pressure or pulse on either arm. When the doctor arrived, he gave me epinephrine, which stabilized me so that I could be taken to surgery. Sometime later, when I could talk again, I told my husband that he should have just leaned over and said “CVS Caremark” to me. Hearing their name is enough to get my blood pressure up without any medication at all!