Tom Curtis: New Problems With Express Scripts/Medco Mail Order Program

From Tom Curtis, January 10, 2013

2013 Brings New Problems With Express Scripts/Medco Mail Order Program

by Thomas Curtis, STRS Retiree

STRS benefit recipients (BR) who order their prescription medications from Express Scripts/Medco will possibly find many new frustrations when they attempt to refill their current prescriptions online. New prescriptions sent in by a doctor after January 1st may not have any problems. Prescriptions that had refills remaining in 2012, from my experiences to date in 2013 will be a problem.

When I tried to refill 3 scripts online after the first of the year, I was not permitted to do so. These 3 scripts qualified for refills prior to the end of 2012. There should have been no reason why I could not refill them online after the first of the year. I could not refill them because ES/Medco changed the permissible refill dates to February and March.

I contacted ES/Medco Customer Service by phone. After explaining the problem, the CS person simply reiterated that I could not refill the scripts until a future date. I pulled the sheets I received when the scripts were last filled and read her the refill dates on the 3 sheets. I asked her to check the last order for each of them. She told me she had no access to 2012 information and could not provide me with any reason why the refill dates had been changed. I asked to speak to a supervisor, the supervisor had no access to the 2012 files either. I read the refill dates from the sheets I had in hand. She questioned my information. After much discussion, she offered to place a written order for all 3 scripts.

Example: The paperwork that came with the last script for my wife’s Namenda indicated that it could be refilled on 1.10.13. When I got online, the information indicated that the Namenda script could not be filled until 3.5.13. Absolutely no explanation is offered by ES/Medco concerning this problem to date.

Her is another issue that will affect caretakers. I am POA for my wife, as she suffers from dementia. ES required me to complete a form in 2012 to verify my medical POA. Otherwise they would not be able to supply me with any information about my wife’s account (HIPPA). That document did not transfer to the new system in 2013. Thus, I am being sent another form to complete and return to them.

On 1.9.13 I contacted the grievance dept at ES/Medco to file a complaint. I was told they could not accept any grievance concerning 2012, because they had no access to those files. They could not direct me to anyone that could help me.

To date, no one I have been able to reach at ES/Medco can explain why any of this has happened. They cannot change the refill dates back to the ones listed on the paperwork I have in hand. I was told that I would need to call ES/Medco each time this problem occurs and they will hand order each script for me. Oh boy, I get to go through all of this aggravation of calling them to reorder the scripts for how many more refills? This is absurd! Does this whole scenario sound like something that would take place in a communistic country or what?

On 1.9.13 I talked with Greg Nickell and Sandra Knoesel at STRS. They are looking into these issues with ES/Medco.

In my opinion, ES/Medco, the company that STRS has contracted with for our Medicare Part D medications, is a monopoly that totally dictates what we must do to get our medications. Simply put, we are rats in an ever-changing maze. If a customer has a problem with a script, it is our problem, not theirs. In their minds, the customer is wrong until proven otherwise. If the BR chooses to go to their local pharmacy rather then deal with ES/Medco, they will pay far more for their scripts and be limited as to the number of pills that can be dispensed. ES/Medco will not permit a local pharmacy to fill many scripts for a 90-day quantity. What ES/Medco refers to, as Customer Service is an oxymoron. The merging of ES and Medco file systems this past October was disastrous. Their own employees were not able to access information for weeks. Now comes 2013 and the very same issues are at hand. It is my hope that this information will be of help to other BR and their caretakers. Working with ES/Medco for my wife and my prescriptions has been one of sheer stress and frustration.