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YOUR Insurance Company MAY Be Putting YOUR Health at Risk Our family has utilized BCBSNC for many many years with little or no complaints at all. They have been the best about offering affordable plans, lower rates when most other insurance companies were simply astronomical. BCBSNC has always included most of my health providers and my beloved Robinhood Family Pharmacy. But now, they might not. Now, they may put my entire family's health at risk as well as countless others. You see, I saw THIS letter posted in the pharmacy when I was there:
"Re: Termination of ROBINHOOD FAMILY PHARMACY LLC from Prime's Networks
Dear Pharmacy Owner or Manager:
Prime Therapeutics LLC (Prime) has made enhancements to its network participation criteria regarding Prescription Drug Services thresholds for pharmacies participating in Prime's pharmacy networks. You have been identified as currently processing compound Prescription Drug Services that exceed ten (10%) percent that does not comply with Prime's network prescription criteria.
This letter serves as notice that Prime is invoking its right to terminate ROBINHOOD FAMILY PHARMACY from Prime's pharmacy networks. Pursuant to the Section titled "Term and Termination" of the Prime Therapeutics Pharmacy Participation Agreement ("Agreement") between Prime and Epic Pharmacy Network, Prime Therapeutics will terminate the Agreement effective December 1, 2016.
If your Pharmacy believes its dispensing practices for compound Presciption Drugs Services complies with the described above and you wish to appeal your pharmacy's termination, please submit a written appeal to the Pharmacy Network Contracting Department within 30 calendar days or as otherwise required by law with this letter to pharmacyops@primetherapeutics.com. Prime will review your request and provide a response to your Pharmacy based on its determination.
If you have any questions concerning this letter, please contact us at pharmacyops@primetherapeutics.com or at 888.277.5510 option 1.
Sincerely,
Prime Therapeutics LLC
Pharmacy Network Management
cc: Epic Pharmacy Network"
PO Box 64812 St. Paul, MN 55164-0812 tel 612.777.4000 toll free 800.858.0723"
My apologies but 10%? I didn't realize that BCBSNC or Prime Therapeutics or Epic Pharmacy Network had the right to tell their customers that only 10% of their health was allowed to be taken care of.
What Does This Mean? Basically, it's about money. Because more people are utilizing compounded prescriptions, it means less money directly to specific pharmaceutical name brands, which means people who work for Epic Pharmacy network and/or Prime Therapeutics get a call from those pharmaceutical companies who are now unhappy due to lack of use of their products. This is how smaller pharmacies lose some of their customers who rely on what they have found to be the safest prescriptions alternatives for their health. Did you read that BCBSNC and Prime Therapeutics Epic Pharmacy? THEIR HEALTH. Don't understand? Let me explain it quite simply- these are your customers who pay to have your coverage. Much like me, these consumers choose your plans because you offer exactly what they need and are thankful that you offer it. These same customers may have specific health issues that require a compounded prescription versus a brand name medication because if causes horrible side effects. Just as there are reasons to prescribe a medication, there are just as many reasons if not more not to prescribe medications for certain individuals.
My Blunt Plea to BCBSNC, Prime Therapeutics and Epic Pharmacy Network Not only do I demand to utilize my right as a consumer to continue to utilize the pharmacy that best suits mine and my family's needs but I demand that you renege your previous decision to remove Robinhood Family Pharmacy from your list of accepted participating pharmacies for your network. I know these people even though your companies do not. I know that they truly care about all of their customers, their specific needs and I trust our lives with their staff. I know that if I fill a prescription with them and I forget to check on any minute details (such as possible allergens in a prescription) they will immediately make me aware of what it includes and what our family's safest options are for us to choose from. And, they do it with a patient, warm, friendly smile every single time. BCBSNC, Prime Therapeutics and Epic Pharmacy Network- can you honestly say that your pharmacy does that for you and your families? I highly doubt it. I urge you to contact Robinhood Family Pharmacy or any of their customers to ask questions if you are still doubtful. Your customers are what keep your companies in business each year. The voice of your customers is what shapes your plan needs, what helps you to decide how to continue to be preventative companies and your customers are the people that will be the people who will choose to stay with your companies or find others that do not cut off what is their lifeline to staying healthy and well. When a doctor writes a prescription for a compounded prescription, there is a really good reason for it. Is this not something that any/all of your companies feels is a stepping stone to keep your companies as a forerunner in the health industry?
So BCBSNC, Prime Therapeutics and Epic Pharmacy Network- I am begging you to be the better company for ALL of your customers as well as my family. Be the companies that are in the news for a good and decent reason rather than a negative one. Be a part of your consumers voices and show us that you are here to work with us, not against us. As I stated previously, my family has been in your care for many, many years. If we had to choose another health care provider, it would be upsetting but if we had to choose an entirely new pharmacy that doesn't give a tiny inkling about our health, that would be devastating and detrimental to our health.
I also urge everyone else reading this to contact your current health insurance carrier and make sure that your consumer rights and health are not being controlled.
I think if even .01% of the population called their insurance brokers and insurance companies to share that they will be shopping for new insurance that does not try to dictate their health--above physician recommendations, then here might be change. Good job in calling your insurance carrier. I told mine I was shopping and they "attempted" to help me get the Generic Adrenaclick covered
ReplyDeleteI truly hope that BCBSNC and the other partnered companies will understand why keeping this pharmacy option is so necessary <3
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