Blue Cross Blue Protect insurance coverage buyer upset about prescription profit change

SIMPSONVILLE, S.C. (FOX Carolina) – Stephanie Baker says a yr in the past she began getting her medicines from Howard’s Pharmacy in Simpsonville.

“They have been native and I actually needed to help an area enterprise right here in Simpsonville,” Baker stated.

However this yr her pharmacy informed her she would quickly must obtain her upkeep medicines by means of OptumRX mail service or CVS if she desires them lined by insurance coverage. Upkeep medicines are prescriptions generally used to deal with circumstances which are continual or long-term. She says her insurance coverage is thru Blue Cross Blue Protect of South Carolina.

“Initially I used to be very upset as a result of I really feel it’s my option to resolve what pharmacy I’m going to and I’ve been utilizing Howard’s for just a little over a yr,” Baker stated. “I specifically left CVS and got here right here they usually have been unbelievable.”

A spokesperson for BCBS of South Carolina launched an announcement. It stated partially:

“January 1 of every yr can result in modifications to a member’s healthcare plan protection. The forms of modifications rely largely on the kind of plan a member has. The plan could also be one their employer gives; one obtained from healthcare.gov; or a authorities program resembling Medicare or Medicaid. Many modifications can save a member cash or might make entry to healthcare simpler.”

Scott Causey is the co-owner of Howard’s pharmacy and says this modification has occurred to a number of individuals. He says Howard’s Pharmacy began in 1934 by his spouse’s nice uncle.

“I positively assume it’s unlucky as a result of the client must have the flexibility to decide on the place they need to go,” Causey stated.

Dr. David Wilcox from North Carolina wrote a e book about “How To Keep away from Being A Sufferer of the American Healthcare System.” He says even when an individual will get a prescription out of community, it might be cheaper if the client pays money.

“If somebody desires to have a look at GoodRX, which offers with coupons and rebates from pharmacy profit managers, then they are able to decrease their preliminary worth,” Wilcox stated.

BCBS of South Carolina additionally launched the next assertion.

“There was a prescription drug profit program change for ACA particular person/relations for medication thought of upkeep medicines. The change was made to this system because it provided vital cost-savings to the member. And, by selecting a 90-day provide supply of medicines, a member with a continual medical situation can extra constantly take their medication. This remedy adherence can result in higher well being outcomes for the member. “

Baker says regardless of her insurance coverage modifications she goes to proceed with Howard’s pharmacy and pay the out of pocket prices.

“The factor that bothered me essentially the most was that we weren’t informed,” Baker stated. “It wasn’t listed in our coverage. We referred to as our agent and had him confirm and he was unaware of it.”

BCBS of South Carolina says if an individual is uncertain about his/her prescription advantages to name the quantity listed on the insurance coverage card.

Copyright 2023 WHNS. All rights reserved.