PITTSBURGH (KDKA) — Finding out you might have to pay for hundreds of dollars worth of prescriptions out of pocket is not a happy way to start the New Year, but that’s what some drug store customers have been facing.
“It is a shock, they’re not expecting that,” says pharmacist Gino Cordisco of Medfast Pharmacy.
On Jan. 1 and 2, some people had trouble if they had UPMC’s health plan. The problem is with Express Scripts, the processor for UPMC prescription claims. With its new processing computer program, patient information had not been fully updated.
This pharmacist says this is nothing new for this time of year.
“It happens to several other insurance companies in other years,” says Cordisco.
At this local chain, customers are still able to get their medicine.
“No one is without medication due to insurance reasons,” says Cordisco. “In my experience, they have gotten the problem fixed rather quickly.”
The problem of verifying eligibility only affects a small percentage of members, with everything fixed by tomorrow, according to an email from UPMC Health Plan.
The statement goes on to say “all pharmacies were asked to, at a minimum, issue a temporary supply.”
Some larger chain pharmacies are being more rigid. If you’ve had to pay full price, you can download a reimbursement form on the UPMC Health Plan website. Click here to find the forms.
If you’re having issues, your pharmacy can likely work with you. You may not need to pay the entire out of pocket cost, just the co-pay, and the pharmacy will rebill Express Scripts again later after the computer issues are fixed.