CCRX Plan D Prescription Medicare Drug Plan
Queja 101492 Detalles

Hello

I am disabled. On or about December 15, 2011 I selected CCRX as my prescription plan D company. Immediately after doing so I contacted CCRX to ensure that they had it documented in their system that I receive “Extra Help” through Social Security for I meet the guidelines set forth which classifies me as a low income household. They assured me that the data verifying my “Extra Help” status was in their data base, therefore my reduced medication co-pays would reflect this fact when my prescriptions were filled beginning in January 2012.
On January 1, 2012 while filling two prescriptions at a local pharmacy it was conveyed to me that the co-pay amount was $78.00. This was approximately $73.50 more than I was accustomed to paying. After contacting CCRX immediately I was told to call back however; after doing so they stated the amount of my current co-pay was in fact correct.
After numerous calls to CCRX (in excess of 5) I was told that their system did not reflect my “EXTRA HELP” status and that Social Security would have to confirm it. I contacted Social Security, who said verification had been forwarded to CCRX. I contacted Medicare who confirmed the same information. At this point CCRX was contacted by me again and they neglected to confirm that they had in fact received the verification of my status from the Social Security and Medicare.
By this time it was February and my medications were due to be picked up again. As before, my co-pay was in excess of $78.00.
I contacted Medicare an additional time and the cordial lady confirmed my status again and suggested that I immediately change prescription Plan D companies. Her advice was taken and immediately from that point forward I was issued a membership card from my new company and my co-pays were reduced to the amount I was eligible for within the “EXTRA Help’ guidelines.
Now it was time to attempt to recoup the substantial dollar amount that had been paid out of pocket that contradicted Federal law.
There have been in excess of ten phone calls made to CCRX regarding my reimbursement and during one of them a very competent employee simply accessed the Medicare database and confirmed what everyone else (including managers) had denied, that I had been eligible for “Extra Help” the entire fiscal year. She promptly put a manager on the phone and I was told that a check would be forwarded within ten days for the amount I had over paid out of pocket. The manager knew the exact amount of over paid funds, to the penny.
I patiently waited ten days. I waited for twenty days. I called CCRX again. During this phone conversation with a manager I was told that what I had been told earlier regarding a check being forwarded for reimbursement was incorrect. Now I was instructed that forms would have to be forwarded to me and they would have to be filled out by myself as well as the pharmacist that had actually filled the prescriptions. I was told that once the forms were returned I could expect my reimbursement within ten days. The forms he was suppose to forward to me never showed up so after approximately ten days I called CCRX to request the forms again. Finally, I received them. It was time consuming and somewhat expensive however I had no choice other than to comply.
Upon returning the forms accurately to CCRX in a timely manner I waited. Again, I waited ten days. I waited several more days. Eventually I called CCRX again. During this conversation CCRX acknowledged receiving the forms for they were sent with signature confirmation, at my expense. It was conveyed to me that the forms were being reviewed and that my reimbursement could be expected (if approved) no sooner than 90 to 120 days.
This entire ordeal leaves me at a loss. I look at the situation as larceny. There were two weeks that comes to mind, where my wife and I had to go without food due to the co-pays of my medications. I qualify for “Extra Help” because I qualify for the low income family program. It is a very helpful sliding scale program until you run across a vendor that abuses the system and utilizes every untactful method at their disposal to avoid honoring a contractual agreement in which they entered into with Medicare.
Finally, all I can say is that it is an unfortunate series of events and the reimbursements due have yet to be made.
Please, if you can assist me in any way to resolve this issue it would be greatly appreciated. I have contact the Commonwealth of Virginia State Corporation Commission Bureau of Insurance, the Agency on Aging and have yet to have this situation expedited. I truly feel that CCRX owes me additional funds beyond the excessive co-pays. For example, the cost of numerous phone calls, expensive registered mail, fuel to travel from pharmacy to pharmacy to obtain information that CCRX had within their own system and any potential interest that could have accrued on these funds.
Thank you for your attention regarding this unfortunate series of events. Please contact me if you can/or cannot assist me with this matter or if you require any additional information.

Kindest Regards

(Personal information removed)