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Old 01-10-2012, 05:13 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,949,478 times
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Odd question, but interesting enough that out of curiosity I thought I'd take a chance at getting feedback. A friend is dropping her health insurance next month for financial reasons. She has her own individual policy, it's not through work.

Prior to making this decision, her doctor called in a prescription for a cream the pharmacist needed to mix up... it's not a ready made pill. It's $200, so she's decided it's not an urgent necessity & to go without that, as well. In all actuality, she simply doesn't have the money.

Her dilema is wondering how to best handle not picking it up. If you order a prescription for pills & they're not picked up within a certain amount of days (4 days normally), the pills are placed back into their containers after a reminder call to the patient (happened to me once when I forgot a prescription was dropped off) & all is forgotten. However, since the pharmacist had to specially mix this cream for her, what would happen?

Her insurance won't cover the cream, by the way, so I'm guessing they won't be billed by the pharmacy. Will the pharmacy bombard her with calls or mail? They called her once & she had not yet decided what to do about insurance, so just said she'd pick up the prescription in a few days.

She's frantic about her finances now, so her mind is racing & she's expecting the worst. I suggested she call the pharmacy to explain she can no longer afford it & to please cancel it (or, I'll call for her), but she feels they'll tell her she's liable & must pick it up or they'll bombard her with invoices or call her doctor or insurance company. She feels if she doesn't answer future calls & lets them leave voice mail, she can claim to never have received any reminder calls & they'll give up sooner or later. It may all sound silly, but I know the dire straights she's in, so sympathize with her situation. I also understand that the pharmacy may not be able to re-sell this cream, since it was some sort of special cream made for her minor condition.

Does anyone know if the pharmacy will just discard it & chalk it up to a loss? Has this happened to anyone else? I'm guessing most would say, buck up & call the pharmacy, but, I was hoping to solicit opinions for her. She's in a sad state financially through no fault of her own, so I do understand her distress.

Thanks for any input. She'll really appreciate it.
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Old 01-10-2012, 05:19 PM
 
Location: home state of Myrtle Beach!
6,233 posts, read 18,119,501 times
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Sometimes those things aren't mixed up until the patient comes in to pick up the prescription. I'd call the pharmacy and explain the situation. It sounds like she has had this filled before so maybe she can remember if she had to wait while they mixed it.
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Old 01-10-2012, 06:11 PM
 
Location: Islip,NY
16,926 posts, read 19,666,757 times
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Just have her call the pharmacy and explain her sitiuation and that she cannot afford the medication and that she won't be picking it up. I know they will understand.
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Old 01-10-2012, 06:13 PM
 
Location: Boonies
1,770 posts, read 2,584,606 times
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Maybe they will give her a good discount.
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Old 01-11-2012, 08:03 AM
 
Location: Tigard, Oregon
851 posts, read 2,475,250 times
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She just needs to call and tell them the situation. It's really all she CAN do. Continuing to ignore it will only cause her added stress by NOT knowing where she stands and "worrying" about what "might" happen. I believe the outcome will be better than if she just ignores it. She will certainly feel better about it. I wish you both well!
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Old 01-11-2012, 12:16 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,949,478 times
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Quote:
Originally Posted by myrc60 View Post
Sometimes those things aren't mixed up until the patient comes in to pick up the prescription. I'd call the pharmacy and explain the situation. It sounds like she has had this filled before so maybe she can remember if she had to wait while they mixed it.
It's already mixed & ready for p/u. Her doctor called it in Wed last because it would take a few days to mix up... it's a special pharmacy which specializes in mixing tinctures. She called the pharmacy last Sat to find out if it was ready... that's when she found insurance wouldn't cover it & she'd need to pay $200. She's never had this particular prescription before, so was stunned & just said she'd p/u in a few days... then the whole fiasco happened with finances, poor dear.

It's been 1-wk now since it was called in... to alleviate her guilt at avoiding picking it up (she feels humiliated to call the pharmacy directly), I'll ask her if she'd like me to call them for her today.

Thanks for your input... the more opinions, the better.
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Old 01-11-2012, 12:20 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,949,478 times
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Quote:
Originally Posted by lubby View Post
Just have her call the pharmacy and explain her sitiuation and that she cannot afford the medication and that she won't be picking it up. I know they will understand.
Thanks, Lubby. I've never run into this situation before so wasn't sure what their stance would be on a specially mixed cream. I'm gently suggesting she call first. If they're insistant she p/u, she could just tell them to store it & she'll p/u if/when she has the funds.
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Old 01-11-2012, 12:32 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,949,478 times
Reputation: 3424
Quote:
Originally Posted by tarragon View Post
Maybe they will give her a good discount.
Great advice, never thought of that. She has insurance through the end of the month, but, this prescription isn't covered by insurance anyway. Not sure if that will matter to the pharmacy or if they'd only offer a discount for a cash pay patient sans insurance?

In addition, she got caught offguard by her deductible not rolling over. She purchased her own insurance mid-year 2011 & assumed the deductible (which was fully paid in 2011) would apply for 1 full year... wasn't prepared that it 're-set' on Jan 1, so she's responsible for the high premium (it's the first time her insurance isn't through an employer) & the deductible. In any event, she can no longer afford the premiums, so will drop insurance on Feb 1. What a sticky situation.

But, thanks for the advice. I'll let her know she could at least attempt a negotiation. Thanks, Tarragon (aka Spice Girl)... yuk, yuk, yuk
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Old 01-11-2012, 12:36 PM
 
Location: Temporarily, in Limerick
2,898 posts, read 4,949,478 times
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Quote:
Originally Posted by zoso1979 View Post
She just needs to call and tell them the situation. It's really all she CAN do. Continuing to ignore it will only cause her added stress by NOT knowing where she stands and "worrying" about what "might" happen. I believe the outcome will be better than if she just ignores it. She will certainly feel better about it. I wish you both well!
I completely agree. I've told her the same, but, know of her embarrassment over her sudden $ situation, which is why I offered to call them myself. I'll let her think about it overnight & push her a bit more tomorrow to let me call, if she prefers. Avoidance, I find, is much worse because you roll it around in your head hour upon hour. Thanks so much!


By the way, thank you kindly to everyone who replied. I'm impressed by the kind, considerate, gentle suggestions & replies. Cheers to all of you for that!

I'll post back tomorrow once she's either called, or lets me call. This post was just more my curiosity at what would happen to the ready made cream, if she'd be responsible for the cost & hoping to get some insight into something she hadn't thought about... like negotiating the price.
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Old 01-11-2012, 12:48 PM
 
Location: home state of Myrtle Beach!
6,233 posts, read 18,119,501 times
Reputation: 3419
Quote:
Originally Posted by PatanjaliTwist View Post
I'll post back tomorrow once she's either called, or lets me call.
HIPPA maybe violated if you make that call.
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