Need help with prescriptions and insurance company

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Da5id
New Member


Date Joined Jan 2011
Total Posts : 3
   Posted 1/22/2011 6:57 PM (GMT -6)   
Hi, I'm new to this forum. My father is in an Alzheimers wing of a care facility. He is well cared for and comfortable with his surroundings. I live in another state and am the durable Power of Attorney. My brother who lives in the my fathers city is the power of attorney for health care decisions. This arrangement has worked well however I have run into a dilemma that I am having difficulty breaking through.

The facility where my father lives strictly controls the administration of his medicines and I understand why that needs to be. They get them through a pharmacy that is affiliated with the facility. My father has health insurance through his retirement from Foot Locker with United Health. This health care requires that prescriptions are obtained through the mail from Medco which is what happened for years prior to his admittance. The pharmacy said that I need to get some form of "bypass" from UNH or Medco but whenever I talk to someone at these companies, they act like it's the first time in history this situation has ever come up and tell me to call the other one. This has been going on for 2 years now and we have been paying out of pocket the whole time which has now gotten into the 5 figures of expenditures. The fact that I have to do this from another state adds to the frustration.

I am hoping that someone here is familiar with this process and can help me get to the right people with the right phrasing of the problem.Thanks in advance.

Red_34
Elite Member


Date Joined Apr 2004
Total Posts : 23551
   Posted 1/22/2011 7:36 PM (GMT -6)   
They shouldn't be giving you the run around. When I had my Gma in assisted living, she got her prescriptions thru Medco. At first I just had them send the meds to me and I would deliver them to the AL center, however this got to be a bit much so then I switch the address to the assisted living center (with the approval of the manager) and I would order her refills online. The AL center would let me know when she was running low on medications. Try talking to the administrator of the care facility and see if there is an easier way around this. As a side note, my Gma's insurance was Blue Cross/Blue Shield provided thru my Gpa's employer (Ford Motor Co). I never had an issue with the medications.
SHERRY
Moderator-Allergies/Asthma and Alzheimer's, Co-moderator-UC
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billye
Regular Member


Date Joined Nov 2009
Total Posts : 24
   Posted 2/5/2011 3:03 PM (GMT -6)   
please contact a state consumer advocate from the insurance dept or the health agency.  you should have an advocate in that facility.  write one letter detailing the whole situation.  keep it current.  send to the resident manager also. 

Da5id
New Member


Date Joined Jan 2011
Total Posts : 3
   Posted 2/5/2011 6:51 PM (GMT -6)   
Thank you all for your responses. I knew there was something like an advocate...I just didn't know what it was called :)

billye
Regular Member


Date Joined Nov 2009
Total Posts : 24
   Posted 2/5/2011 7:50 PM (GMT -6)   
call the state attorney general---------------send them the detailed letter. the ag scares all businesses.

MT Lady
Veteran Member


Date Joined Jul 2008
Total Posts : 969
   Posted 2/12/2011 1:31 PM (GMT -6)   
Also contact AARP...oftentimes they will get involved. I undestand what you are going through. The AL facility where my mom lives has the same rule

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