I order my insulin from Express-Scripts.
My OP is 120.00 max on any RX, so if I get a months worth of insulin it's 120.00 and if I order a 90 day supply from Express-Scripts (Mail Order), my cost is the same (120.00). Many mail order drug Co also have cost based on diffrent tier levels. Example generic drugs on my plan are covered 100% no OP cost.
Unfortunitly analog insulin has never been considered generic.
"all diabetic supplies" probably refers to durable medical equipment (DME).
"Customer Care" at your pharmacy benefits manager means they care to fit you into doing what THEY want, not the other way round. Once you get it down, it will be relatively smooth sailing until the next time to play the dance.
FWIW, make sure you take names and write every discussion down, so you can refer to them when you call back. Whenever you run into difficulty with a CSR (can't understand them, or they can't seem to answer your questions), don't hesitate to ask for a "Senior Customer Care Specialist".
This 20% is probably the fee the mail order service charges you for using a pharmacy.
My mail order service charges 40%, and this fee does not apply to your out of pocket limit or deductible. I find it unfair, and it stops me from using the local pharmacy, so I can see their point.
I love the credit card approval dance (HEAVY SARCASM)
If they think that the amount is too high to charge to my card without approval, then they need to lower the prices.
The Auto refill service is a bit aggressive, I get over stocked when I use it. Then they ask me if I am using strips, put warning messages on their site that I am not managing my Diabetes...using manual refills again.
Agreed, I love it when the pharmacist asks, "Well, are you testing (or taking insulin) as prescribed by your doctor?" This and the follow-up questions let me know the pharmacist, has no clue about diabetes.
A $1000 copay? Could this be a $1,000 deductible instead? The deductible is the amount of money you have to pay out-of-pocket before the insurance kicks in. The co-pay is that percentage of the cost you have to pick up once the insurance kicks in.
The deductible can be a total health care cost (doctor visits, hospital visits, pharmaceuticals, etc.) that needs to be met before the insurance kicks in. Sometimes, the insurance companies have different deductibles for different health care aspects: $1,000 deductible for pharmaceuticals, $1,000 for doctor visits, etc. It depends on the plan the company you work for set up with the insurance company. If you're confused about your insurance plan, set up a time to talk with your H.R. department and have a list of questions with you to help make sure you get the information you need!