Same thing. Having Prior Authorization problems. Checked BcBs and they don’t require PA for my particular drug.

Switching back.

OP back again -- yet ANOTHER prior authorization lag; I have had to pay out of pocket again for necessary medication because apparently it takes over a week to get Medicare approval for certain prescriptions.

I really don't see how leaving Blue Cross Blue Shield prescription coverage and moving to this Medicare plan benefited us at all. It's just made everything more of a pain, and probably more of a pain for doctors who are having to keep up with all these requests for authorization. I see how it is benefiting BCBS, for sure!

And if Medicare won't cover any medications, BCBS won't have to either.

Anonymous wrote:np here. Is there a deadline for "switching back"?
Also, I'm on DH's Fed BCBS insurance. He also has Medicare but I do not as I am not old enough. So I guessing the FEP Medicare Prescription Drug Program doesn't affect me?

It doesn't affect you now, but will be offered to you when you do qualify for Medicare.

I think overall it probably is a good prescription benefit, it's just that Medicare comes with so many rules and regulations. Also, I don't *think* you can use any pharmacy coupons if your prescription coverage is Medicare.

np here. Is there a deadline for "switching back"?
Also, I'm on DH's Fed BCBS insurance. He also has Medicare but I do not as I am not old enough. So I guessing the FEP Medicare Prescription Drug Program doesn't affect me?

Anonymous wrote:Yep! We are having terrible trouble with “prior authorization “ requirements!! Replacement drug is 10x more.
We are switching back asap.

which drug?

Anonymous wrote:

Anonymous wrote:Whelp. We made the switch and immediately have been having prior authorization problems out the wazoo. Do not recommend.

What does "prior authorization" mean?

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.