Ridiculously messed up. That's the only way I can nicely describe the people working at Anthem Blue Cross/Blue Shield. I have been dealing with different representatives via phone for the past week. Each representative has told me a different process for receiving my Enbrel (my psoriatic arthritis medication). I documented everything each Anthem representative told me. I can't even begin to describe the conflicting information they have given me. Here are just few examples:
- I was first told that I could get my Enbrel at a retail pharmacy (like Walgreens or CVS) as a 28-day supply for $100 per month. About 1 month later, a representative at Anthem told me my plan would allow me to get a 90-day supply for $100. When I asked if it would have to be done through mail-order, I was told that my plan would allow me to do a 90-day supply through mail-order or a retail pharmacy. That sounded great to me. I asked the representative to explain the process. When finished, I had my dermatologist write a prescription for a 90-day supply through my retail pharmacy. The dermatologist even confirmed it with Anthem and the retail pharmacy to make sure it could be done.
- I went to pick up my 90-day supply from the retail pharmacy yesterday. The pharmacy told me that Anthem would only allow me to get a 28-day supply. I immediately called Anthem and spoke with another representative who told me I had to get prior approval. I had already done that when I first was prescribed Enbrel. Then, the lady told me that a 90-day supply would cost $40. I told her that the other representative said it would be $100. Then I asked her to tell me how much I'm paying now for a 28-day supply. She told me I was paying $20 for a 28-day supply. I told her she has the wrong information and demanded to speak with her superior. The representative then hung-up on me!!
- After speaking with four more different representatives regarding my prescription, I'm still being told that I can only get a 28-day supply from the retail pharmacy. (I would go into more detail with the other conversations I had with various Anthem representatives, but that would mean describing a total of more than 4 hours of conversations with representatives and their superiors!) To make matters worse, I have filed three formal complaints with Anthem which they have thoughtlessly neglected to follow-up. I still have not heard a clear, understandable explanation from anyone at Anthem regarding my case.
Some may disagree with me, but that's why I call this type of post "my perspective". Say what you like, but when it comes to treating individuals with psoriasis or psoriatic arthritis, insurance companies, especially Anthem, receive a big fat F in my grade book.