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HMSA and Medco

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  • HMSA and Medco

    Call me irresponsible, but I haven’t been diligently following news and information about HMSA’s new pharmaceutical benefits manager, Medco, which includes their Mail Order Prescription Drug Program. Until now.

    When it was first introduced, I took a quick look at it to see if it would affect me; it looked good, and it looked like it wouldn’t affect me adversely. If you elected to get your medication (maintenance care only) by mail order (a three-month supply), you saved money. If you choose your local pharmacy instead, nothing would change--the price would be the same as you were paying previously. I considered applying for the mail order program to save a little money, but ultimately chose not to, primarily because I was worried about late deliveries or non-deliveries. I have a history of non-deliveries, the latest being a non-delivery in January from Amazon.com. My address gets easily mixed up with another building with similar numbers.

    A couple of days ago, I ordered a re-fill of one my prescriptions from my usual local pharmacy. Turns out, the co-pay had gone up by 33%. I asked about that and the pharmacist said a lot of HMSA prices have/will be going up. I checked Medco’s drug price listing on their online site, and yes indeed, the co-pay price of ALL of my prescriptions had gone up by 33% if I choose to get them from a local pharmacy. But if I ordered them via their mail delivery service, I would receive significant savings (about $100 per year)--but those savings would actually be a little more than what I had been previously paying at the local pharmacy, about $1 or $2 per month more. In other words, no matter what, the price for everything has gone up, and I had two choices: pay 33% more than what I had been paying for in the past by maintaining my loyalty at my local pharmacy, or go with the mail order service and save significantly, which would amount to $1 or $2 more per month than what I’ve been previously paying. I believe this pricing change has just recently gone into effect (like July?).

    I’ve decided to go with the mail order service the next time my re-fills comes up, but I really don’t like the way this seems to have been forced upon me. I remember reading (sorry, I could not find the article) that State (or City? or some other government faction?) workers were recently forced into accepting one of these outsourced pharmaceutical services (not Medco) and there were complaints. In one instance, someone on the Big Island had to go to the emergency unit of a hospital because his mail order medication had been delayed. I believe he had heart problems.

    My other concern is that I like going to my local pharmacy. They know me and go out of their way to help me. This mail order service, which may save us some money (always a good thing), would most certainly hurt local pharmacies, which in turn could ultimately hurt us in other ways.

    Is any one else concerned about this? Or am I just being a little too paranoid?

  • #2
    Re: HMSA and Medco

    I don't think you are paranoid at all. I have Medco, too, but don't have a need for it and fill all my prescriptions at my local pharmacies. I think if I had a new longterm prescription, it would really depend on my financial situation.

    Call Medco; talk with a pharmacist about your meds. You might be able to arrange another type of delivery or another address (like the doc's office or a local pharmacy.) If your meds require close monitoring and discussion with pharmacists, it might be better for your health to get the med close to home. But give Medco a chance; see if they can provide any of that for you. I would explain my concerns to them and see what they say.

    If they won't talk with you about your needs or help you, report it to HMSA and to your doctor.

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