Pharmacy was running my prescriptions through Medicaid I haven’t had in 4 years??
Hey, so I have something weird going on that idk how to navigate. Here's a quick timeline:
-stopped working October 2019 and got on Medicaid (Iowa Total Care)
-started new job in December 2020, no longer eligible for Iowa Total Care. Did not have insurance until May 2021 because I could not afford my recruiting company's plan and couldn't get coverage through my company until I was hired on.
-had an Aetna narrow network plan through job from May 2021 until December 2022
-switched to a United Healthcare plan through same job at the beginning of this year
-was involved in downsizing layoffs on 3/6/2023. Although I'm not working, am still technically employed at my job, getting paid, and receiving my benefits until 5/6/2023
-Since January I've been seeing a psychiatrist who has been trying to find me the right ADHD medication. I get these prescriptions sent to Walmart. I have tried 3 medications, 2 we're not authorized by insurance and I paid out of pocket. This last one I was told was 100% covered and I paid nothing in February.
That brings us to today.
Today (3/20) my doctor sent my prescription to Walmart at a higher dose. I called Walmart to check the status and they told me that my Iowa Total Care won't cover the dose increase. I told them that I haven't had or even been eligible for ITC/Medicaid since December 2020 and that I've been using UHC and previously Aetna. When I started using the Walmart pharmacy in January I gave them my current insurance info. They say they don't have it on file, only an active medicaid account. They called the Walgreens that I previously used with my Aetna insurance. Walgreens says that they also only have a Medicaid account on file.
I've had to contact my insurance about prior authorizations etc before and had Walgreens call Aetna for various things. They're both claiming that all they have is Medicaid for me. Walmart said that all of my medications since January have been run through ITC.
I'm so completely confused and irritated. Idk what to do. I'm going to call ITC but I'm concerned. Am I going to be penalized for this? Why wasn't I told this? I have always given my insurance info. My doctors office visits have always billed through my work insurance, so I'm not sure what's going on with the pharmacies.
Does anyone have any experience with this? Am I going to be penalized? What do I do now??
submitted by /u/chhharl
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