Blue Cross pharmacy coverage won’t allow me to refill prescriptions more than two days before the prescription runs out. As a result, I can’t plan ahead; instead, I have to make a mad dash to the pharmacy each time I need thirty more tablets of the only generic blood pressure medication Blue Cross will pay for. Attempts to refill the prescription early are rejected.
I’m fortunate enough to travel frequently, and it’s not unusual for my refill date to occur while I’m out of the country. In the past, I’ve handled this by going to the pharmacy, making a refill request I know will fail, and then guiding the pharmacy staff through the process of filing for something Blue Cross calls a “vacation override.” This requires several pharmacy visits, several calls to Blue Cross’ so-called “Customer Service” number, and a lot of flailing around.
Once again, I’m leaving the country in a few days, and, this time, in an effort to be proactive, I contacted Blue Cross several days early and tried to handle all arrangements in advance.
You know in advance what happened, don’t you?
Me: I’m leaving the country, and need to get my prescriptions refilled early. In the past, this has really caused a lot of runaround at my pharmacy, so I thought I’d call you in advance, make the override request, and see if things can go more smoothly this time around.
BlueCrossRep: When are you leaving?
Me: Monday.
BlueCrossRep: That’s a holiday.
Me: Yep.
BlueCrossRep: You’re leaving on a holiday?
Me: Umm … yes …
BlueCrossRep. *Sigh* Okay, here’s what you’re going to have to do. Go to your pharmacy and try to get the refills. We’ll reject that, because they’re early. Then you have to have the pharmacy call us and request the override. We don’t grant overrides unless you’re leaving within forty-eight hours. But since you’re leaving on a holiday after a weekend, you’ll need to go ahead and request the refill by Thursday, let it fail, have them call us, and remind us that you’re leaving on a Monday holiday, and then we’ll go ahead and fill it on Friday.
Me: You’re kidding.
BlueCrossRep: See, we don’t allow overrides unless you’re–
Me: I understand that. But are you serious that your system can’t handle this sort of thing proactively? I mean, it seems really bizarre that the official process involves waiting until the last possible moment, going to the pharmacy to have a request rejected before it can be handled, and then having to make a second trip back to the pharmacy two days later.
BlueCrossRep: That’s our policy.
Me: So I get to make two trips to the pharmacy: one, forty-eight hours before I leave the country, just to be turned down … and another, right before I leave the country, to actually get my medicine. Does that sound like a customer-focused policy to you?
BlueCrossRep: Well, some insurers don’t allow overrides at all, and with them, you’d just have to pay out of pocket.
Me: But I don’t do business with them. I’m just saying: this seems to be a process that’s designed to maximize effort and frustration for the customer and the pharmacy.
BlueCrossRep: That’s our policy. Is there anything else I can help you with today?
It comes down to this: at Blue Cross, “customer service” is a metaphor for “a system of hoops designed to frustrate our customers so completely that they will pay out of their own pocket rather than call on us for the services that their premiums are supposed to pay for.”
As consumers, we struggle to qualify for and keep expensive policies that, in the end, often cost more than medical care does. Companies like Blue Cross know we have little or no ability to shop elsewhere … and so, like any monopoly, they take advantage of us at every possible opportunity.
Unsurprising. At least one of the reps came clean with you about it, not that that is of any help.