Reply to Retired Fed - Switch to FEP Medicare Prescription Drug Program?

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Reply to "Retired Fed - Switch to FEP Medicare Prescription Drug Program?"

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]Whelp. We made the switch and immediately have been having prior authorization problems out the wazoo. Do not recommend.[/quote]

What does "prior authorization" mean?[/quote]

The pharmacy won't fill my husband's prescriptions until the insurance company (Carefirst FEP Medicare) says that they will cover it. The pharmacy needs prior authorization which will last for one year.

To get the prior authorization, first I had to call the insurance company to inquire what the problem was as these were drugs my husband had been on for years with no problem from BCBS FEP.

The insurance company said that they had sent over the necessary forms needed to be signed from the doctor answering questions about why these drugs were necessary.  The doctor is a busy person and doesn't have time for all these forms, so that took a long while.

Turned out, my husband is taking some medications that can be used to prevent organ rejection after a transplant. They are cheap drugs. He isn't taking them for a transplant.   Medicare DOES cover these drugs, no problem, but if you are taking them for a transplant, Medicare Part B covers them, so Medicare Part D (which is what the FEB Medicare Prescription Drug Program is) doesn't cover them. So we were trapped in that cycle for a while till it got figured out.

I do want to switch back to regular BCBS prescription insurance, but am worried it'll be a big hassle now. This new program just has too many Medicare rules and it isn't saving us any money.[/quote]

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