Rx Insurance

It was bound to happen sooner or later.  My “specialty” meds can no longer be filled at my local drug store.  Instead, for my “convenience,” I’ll have to drive 22 miles to Walgreens, instead of 3 miles to my local pharmacy.  How the &*!%$ is that convenient?!


Methotrexate and Cimzia are both on the list.

Now, I realize that one option is to get prescriptions through the mail, but I have heard so many horror stories about the incompetence of mail-order pharmacies that I don’t see that as a very good solution.

Furthermore, one doesn’t have to read very many pharmacy blogs to be aware that Walgreens is one of those pharmacies that have a truly horrible reputation for pushing pharmacists to do more and more work in less and less time, without enough manpower to ensure patient safety.  I guess I can be relieved that my particular meds affected by this are ones that just require slapping a label on the box.

Any suggestions?


10 thoughts on “Rx Insurance

  1. Oh, man, this is tough. I also use a specialty pharmacy. Usually they do mail but I’m fortunate that they’re close enough that I can drive over and pick up my meds. I started doing that when I was on the injectable biologics because, with Texas weather, I didn’t want prescription drugs sitting in non-air-conditioned postal trucks or, worse, on my doorstep. What’s worse, I hate that insurance companies, not doctors and patients are dictating medical treatment. Sometimes you can request an exception, particularly since you’d have to drive more than 20 miles. Good luck with this!

  2. I am required to use the insurance specialty mail order pharmacy, so no help t here. I haven’t had any problems except when Insurance recertification time comes around. I have to work on recerts early. I always worry in the winter that the weather will hold the delivery up. I also have it delivered to my office so it isn’t sitting outside my house. I know that’s not an option for you and hanging around all day waiting for a delivery is very inconvenient. Good luck

  3. Socks, sorry for the pains. When I was taking TNF blockers, Walgreens specialty pharm in Oregon did a wonderful job of processing and shipping on time and packed on ice.

  4. I have my Enbrel delivered to my local pharmacy. I don’t tell them it is a pharmacy it is being delivered to, I just give them the address. The pharmacy is nice enough to accept it and keep it cold for me until I get home from work. That way it isn’t being left on my doorstep. I never had a problem. Over the years there have been three different spec pharmacies. I have to say Walgreens has been the best.

  5. I am also required to use the insurance specialty mail order pharmacy and have for several years. Right now I am using express scripts (curascripts is the specialty). I’ve had no issues and the deliveries always come on time. As long as you can plan on being home when it is delivered, it has worked ok for now. Good luck, hopefully you are surprised and it all works out well. That and you’ll never have a lack of freezer packs for your cooler again.

  6. I hope it works out much better than you expect! No advice here – didn’t even know speciality pharmacies or mail order pharmacies existed – I don’t think they do in this strange, far off planet called England! 🙂

  7. I had CVS Caremark before and it was a nightmare getting my meds. I have Cigna Specialty and so far so issues going on six months. Every company is different. I would give it a try at least. I get my Humira mail order but I am get to consider my Methoxtreate and other meds by mail order. I definitely would save money by doing it but I actually I am concerned that I won’t get my meds. I am concerned that they will require me to soon.

  8. I’m not familiar with RegenceRx as a pharmacy benefits manager (PBM), but I’ve dealt with many over the years including Medco, Express Scripts, CVS Caremark, OptumRx, and Aetna Rx Home Delivery. In my experience, Mail order is generally acceptable, although I have experience with CVS Caremark screwing up. You won’t know until you try it, and your insurance company will nag you endlessly to continue using mail order because its so much cheaper for them.

    An alternative is considering a different insurance company during your open enrollment, although many people have only a choice of being covered or not without a choice of insurance companies. I found United Healthcare and Aetna pretty good, but Wellpoint/Anthem to be terrible.

    One other option is for you to call the insurance company and explain your predicament. They may be able to offer another alternative, such as a nearby pharmacy that your PBM will work with.

  9. Thank you. After much time on the phone with the insurance company, I was told NO DICE. I can get my meds wherever I want, but insurance will only pay for them at Walgreens Specialty Pharmacy. Not much of a choice there, imo.

    The insurance company rep tried to tell me that the employer chose this. Ha! That rep didn’t especially like being informed that whoever told him that was telling untruths. At renewal time, I happened to be the person who read through the reams of paperwork, and I specifically recommended a plan that kept the option of using a local pharmacy. I know that we didn’t choose mandatory mail-order.

    This was followed up with email to our guy in charge, who agreed with me and passed my email along to some head-honcho at the union, who phoned to commiserate with me. It used to be that unions could dictate what they wanted to do, but not any more. Regence inflicted this on the entire union and we have no recourse.

    The union rep contacted some big-wig at Walgreens so that my rx would be expedited. Obviously that didn’t work, since it took three weeks to arrive. Frankly, I find that time-table appalling. We’ll see how long it takes for the second shipment to arrive.

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