Sunday, July 19, 2009

I Prefer My Doughnuts with Sprinkles

Customers are always asking us why their copay is what it is. Some people are downright snotty about it and those are the ones I like to give the 'right-back-atcha' answer -- "well gosh, it's YOUR insurance plan that sets the copay" -- which, also happens to be the only correct answer. But when someone claims their copays are hugely different from last time, I'll try to go to the trouble of looking up what they paid last time, because we all know that someone who claims their copays are totally different probably paid exactly the same amount last month, and I figure if I'm lucky I can confirm that, shut them up and move on to the next person.

I was a little slow this week in realizing that a couple of our customers whose copays went through the roof have hit the doughnut hole (or "coverage gap" in the proper terminology of Medicare Part D). One guy even TOLD me he was in the doughnut hole, but only after I had spent precious time looking up his old prices and making sure we hadn't submitted the claims wrong. So he KNEW he was there but didn't seem to know what that meant ----totally wide-eyed and flabbergasted at his new prices (total: hundreds of dollars, which I know he does not have). The guy just stood there for several minutes and literally didn't know what to do. We have another customer who I noticed has a small bag of meds to pick up and a price tag of over $1000 smacked on the front. I really hope I don't have to ring that one up.

Well, now I will clue in a little faster when this comes up again. It's wicked, though. One more example of how your pharmacist gets to deliver the bad news.

3 comments:

Pharmacy Schools List said...

ouch, meds that cost as much as rent.

do those customers have any other option to get those meds?

pharmboy said...

Hello Frantic,
I've been reading your posts for a while. I created a website, dumbmedicine.com. I'm trying to get people in healthcare to share funny moments with patients, doctors and the like. If you have any, I'd reall appreciate it if you shared them.
Thanks!

Grumpy, M.D. said...

I always know when it's doughnut season because the number of calls I get from people looking for samples suddenly triples.

TAP did a very good posting on this a while back, complete with a hand-out for patients. Not that they'll get it anyway.