When The Cash Price Doesn't Cut It

You'd think filling a prescription wouldn't be any big deal? Apparently that's not the case. There's more to it than that.

Is this something I should know as an adult? Did they teach it in school and I simply wasn't paying attention that day? Was there some aged wisdom my mother and father should have passed down to me about dealing with pharmacies? Or is it something else entirely? Because I don't remember anyone telling me there were specific rules or regulations when you first begin taking any sort of medications outside of noting how to take the stuff or consulting a pharmacist if you have questions.

But this story goes beyond that ...

There comes a time in just about everyone's life when age and all its wonders and annoyances begins catching up to you and starts fiddling with your delicate inner workings. Sometimes this is a good thing. More often than not, however, it isn't. 

In my case, I've finally succumbed to what's been passed down to me through genetics: Hypertension. Or, more exactingly, high blood pressure. My mother had it. A vast majority of my relatives on the upper limbs of my family tree had it. I figured I would have to deal with it sooner or later. Now? Firmly planted in my second 50 years of life its decided to rear its head and introduce itself.

It's a simple fix, corrected with a simple high blood pressure medication. No big deal.

So ... after a physical and consultation with my doctor, she prescribed such and asked me where I wanted the prescription filled. "Walgreens I suppose" I told her. "It's right down the street. That seems pretty convenient."

And that's where it was sent. I went in a few days later, handed whoever was helping me my insurance information and answered a few basic questions to get me in the system.

Now, mind you, this is the very first time I've ever had to take any sort of prescribed medication. I've been pretty healthy all my life, reasonably fit, strong and able-bodied. So this whole medication monkey business was something new I was going to have to work into my regular routine: One pill in the morning, continue for six months, then head back to the doctor to check on any progress. Refills are scheduled once a month.

"You're all set, Mr. Noble. We'll contact you when your prescription is ready" I was informed by the Walgreens lady helping me. A day later I had the stuff in my hands.

And then, about a month later, I refilled the prescription. And picked it up. And again. And again. 

But it was the fifth time, refilling it once more, when the confusion began:

"Okay, Mr. Noble ... I have your prescription right here. Hmmmmmm ... you know you're paying the cash price for this, right?" a lady in dalmatian scrubs alerted me.

"Well, yeah ... of course. What else would I be paying? My insurance affords me the best cost for the stuff, right?"

She looked at me with all seriousness. "No. Not when your insurance isn't accepted here."

"What?" I said with a start.

"Your insurance isn't accepted at Walgreens. You're paying full price for this medication. You'd probably get it for less somewhere else at a pharmacy that accepts your insurance."

I was flabbergasted. "Waitaminnit ... this is the fifth time I've come in here for this stuff, for 5 months. And this is the first I've heard that my insurance isn't accepted. Why wasn't I informed from Day One?" (I already knew the answer to this question, that they weren't able to tell me.)

"I can't tell you, I don't know. Has your insurance been altered? May I see your card to verify what you have?"

I dug out my wallet and handed her my insurance card. A moment or two went by and she confirmed: "No, we do not accept your insurance. I suggest your contact your provider and get a listing of pharmacies who do. Do you still want this prescription?"

"Yes, thank you," I told her and handed her the $16.00 I'd been forking over for the past 5 months per usual. She handed back my card to me with my pills. 

Of course as soon as I got home I was on the horn to my insurance. I explained the dilemma. "That's right ... Walgreens - and WalMart for that matter - isn't in our plan. CVS, Rite Aid and several others are. I see you have those locally ..."

"Can you tell me what I can expect to pay at those locations?" I asked her. 

"I'm not quite certain as it depends on the location ... but around $3.25 is my best guess" she replied. 

"Okay," I said. "So now what do I do?"

"You have a few options: You can go to either of those locations or you can start a mail order for your prescription. The mail order allows for a 90 day supply at zero cost to you if you decide that route," I was informed.

"You mean I could have been getting this stuff for free if I wanted?!?"

"Yes" the woman said cheerfully.

I thanked her for her time and set down the phone feeling a bit violated.

I immediately called Walgreens. "Who can I speak with about a problem with my medication?" I asked someone from the pharmacy.

"Jodi is the person to speak with. But she's not hear right now. Can I leave a message and have her get back to you?"

"Please do that," I requested.

I didn't hear back from Jodi after a couple days. The better part of a week went by where I left multiple messages for her. Responses to those messages? Zero. Zip. Zilch. So I schlepped my carcass down to Walgreens one morning. I knew Jodi would be working that day because I'd asked previously when she was in.

She was there. I spun my tale. She let me know she would pass it along to the store manager - Cameron - who would get back to me.

Another week went by where I left multiple messages for Cameron. (Tell me if you've heard this story before.) Responses to those messages? Zero. Zip. Zilch. So I schlepped my carcass down to Walgreens at the end of that week on a Friday to hunt him down. I knew he would be there as I had previously discussed his schedule with Jodi.

Face to face with the man, I explained my situation calmly to him and then launched into what I wanted done about the situation as I handed him a type-written sheet:

"I've documented the dates and costs of all my purchases and taken the liberty of doing the math had I paid what my insurance informed me I should probably be paying. The difference is almost $64.00. I'm looking for reimbursement for that amount for my time and effort," I stated.

"I'm sorry for the trouble, Mr. Noble. I will look into this and discuss it with my regional manager and get back to you. One thing though: You purchased that fifth prescription at $16.00 knowing you could get it for less?"

"Correct. At the time I was running low and hadn't a clue when I got into this process how long the situation would take to deal with. I decided to bite the bullet and get it, even though I was paying an inflated price. I still expect reimbursement for that one in there in light of the fact none of my phone calls were ever returned by either you or Jodi," I explained. "Understand I'm not pleased with the service I've been given thus far, let alone the fact I wasn't informed from the outset my insurance wasn't honored here. That was what got the ball rolling. The only part I'm happy about is finally speaking with someone face to face about my position. Frankly, up until my coming in here and discussing this with you, Walgreens customer service leaves much to be desired. A resolution to this may redeem that position," I admonished.

He took my contact number. I stuck out my hand to shake his, thanked him for his attention and told him I looked forward to hearing back from him as soon as possible.

The next day I received a message. I could come down to Walgreens any time to pick up a cash reimbursement.

Afterward: The following day I put in the remainder of my prescription with Rite Aid. Cost of the stuff there? A mere $1.58 for 30 little pills.