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Medco Health Solutions - Medco Chemo Nazi Says "No Chemo for You!"
Pharmacy Benefit / Health Insurance - Complaint
Review by lindataylor57 on 2012-10-04
Rating: 
FRANKLIN LAKES, NEW JERSEY -- Been paying for health insurance for 25 years. Medco is manager of the pharmacy benefits. I called concerning a chemo drug for cancer. I was put through 3 different reps and over an hour of verbal abuse. First was told " you are NOT covered" Then was told "that's not a preferred treatment" So I asked if it required a prior approval. Answer was " I can't tell you that. You need to contact your HR person." Then I asked, is this a case where there is a generic available? Was again yelled at, " I can't give you that information!" In desperation, I called Blue Cross/ Blue Shield and they connected me to another representative This one tells me my insurance will pay for part of the chemo drug but leaves me with a $200 copay. I asked how they justified such a high copay and got a nonanswer - "That's the copay. Because that's the copay." So now after working and paying health insurance for 25 years, I have to go begging to afford chemo for cancer. The drug manufacturer sent a voucher to cover my out of pocket and I'm hoping the pharmacy will accept it. I HAD a positive attitude and now I am totally stressed out. Medco makes the Fortune 500 profit list on the backs of cancer patients. Their customer service reps are taught to lie and deceive customers to maximize profits. I called back to get an address but no name for the company president is either given, nor listed on the Internet. If I ran a company this way, I would be embarrasssed to list my name too. There should be a special place in hell for Medco. The Devil is alive and well and doing business in New Jersey.
Comments:
Posted by trmn8r on 2012-10-04:
Is this a health insurance issue (BCBS)? The insurance dictates what is covered and what isn't, doesn't it? I don't see what Medco did wrong here.
As far as justifying the amount of a particular deductible or copay, this doesn't seem like something anyone will be able to tell you - it is probably quite complicated and based on statistical analysis of past claims, your yearly premiums, etc.
As a pharmacy provider, I used Medco for 3 years and had no problems with them.
As far as justifying the amount of a particular deductible or copay, this doesn't seem like something anyone will be able to tell you - it is probably quite complicated and based on statistical analysis of past claims, your yearly premiums, etc.
As a pharmacy provider, I used Medco for 3 years and had no problems with them.
Posted by spiderman2 on 2012-10-04:
I'm sorry for your troubles. Your level of insurance coverage is picked by what your employer pays for. This is why you were referred to your HR person. Not everyone has the same levels of coverage. My family has great coverage but we pay over $1500/month for it. If we were on the $500 a month plan there would be a lot more copays.
Please don't let them stress you out. I know this is easier said than done. Find out if there is more help you can get from the drug company and ask your oncologist for direction. Again, best of luck to you in your fight.
Please don't let them stress you out. I know this is easier said than done. Find out if there is more help you can get from the drug company and ask your oncologist for direction. Again, best of luck to you in your fight.
Posted by Alain on 2012-10-05:
You may find this website useful: http://www.state.nj.us/dobi/division_insurance/index.htm
Posted by CowboyFan on 2012-10-05:
The fact that the op paid for insurance for 25 years has no bearing on the issue, because for each of those 25 years they got exactly what they paid for - coverage. Insurance companies do not save up your premiums to use for your care later.
The suggestions about contacting your HR representative and discussing your coverage is a good idea, because this illness may take a while to be treated and many other issues will arise. Knowing what is and is not covered, and preparing for it, helps reduce the stress. Good Luck.
The suggestions about contacting your HR representative and discussing your coverage is a good idea, because this illness may take a while to be treated and many other issues will arise. Knowing what is and is not covered, and preparing for it, helps reduce the stress. Good Luck.
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