$500 in Prescriptions – Payment Denied

We made the last co-pay of $145 to Mr. A’s COBRA insurance in August, so his coverage is probably over by now.  Of course, last Thursday we get a notice in the mail that his insurance company can’t pay for some prescriptions filled back in December and January.

Here’s what they said:

Dear Mr. A:

Our records indicate that INSCO insurance company paid for the following prescriptions after you were no longer covered under the member ID listed below. You may have changed employers and received a new INSCO member ID number, or you may have a new insurance carrier to whom these claims should have been submitted.

In order to take full advantage of your prescription benefits, either though XXX or your new prescription drug insurance carrier, please request that your pharmacy attempt to reverse and rebill the prescription claims under your new member ID number. Depending on the billing requirements of your new insurance, the pharmacy may not be able to reverse and rebill the claims. If the pharmacy is unable to rebill the claims, please contact your new insurance carrier to find out the steps that need to be taken in order to submit these prescriptions to them for reimbursement.

Thank you in advance for your cooperation. Please remit payment to INSCO in the amount shown below so we can update our records and avoid sending future collection notices. Please make your check payable to INSCO and enclose in the return envelope provided for your convenience. If you have questions about this notice, please call 1-800-xxx-xxxx.

I just get so weary of fighting all the time. These prescriptions come to $569.29 and were filled by TWO different pharmacies.

I guess INSCO wants us to pay them first, and get reimbursed by them later, because Mr. A was covered by them the ENTIRE time, much to his dismay.  He thinks all insurance is a ripoff.

I should have called on Friday, but I wanted one day of peace and quiet.

*INSCO is short for Insurance Company and a fictitious name to protect the identity of the real insurance company.

Yours Truly,

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3 thoughts on “$500 in Prescriptions – Payment Denied

  1. Ugh, I hate health insurance. It seems like it’s all crap to me!


    Mrs. Accountability Reply:

    Hi Mrs. Money, well, I guess I have to admit I’m not the hugest fan myself, but I do worry about catastrophic medical events that could bankrupt us. We have seen first hand what happens when we have insurance, and when we don’t. Once Mr. A and I both went to the same podiatrist, about six weeks apart. Mr. A went first. It cost $50, he was diagnosed with plantar fasciitis, given some inserts and sent on his way. When I went in with insurance, first I had to pay $20 to my primary care physician to get my referral, and then $40 co-pay to the podiatrist. I got the same diagnosis, same inserts; however, they wanted me to come back for some kind of specialized x-rays, which no doubt would have cost the insurance company a bundle. Thanks for visiting and commenting!


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