Deductible for specialty medication with Aetna and CVS Specialty
Hi all, I recently joined a new company and had to refill my specialty prescription. CVS by default used savings coupon and then on Aetna's website it shows that I met my deductible. But that should not be the case, as my plan documents clearly says savings coupon amount will not be used to meet deductible.
So I called CVS Specialty, and they said it first went through my primary insurance which is CVS Caremark(Aetna subcontracted specialty) and I still had deductible, so they ran through my secondary insurance(savings coupon). I'm not sure why they called savings coupon an insurance. I asked them why it shows that I met deductible with a coupon, and they said apparently it is my personal deductible which was met but not the family deductible. It didn't make sense as our plan clearly says we have a family deductible and it confused me. I asked them to rerun the claim with my card, as I wanted to use rebate. This way I could meet deductible without using coupon. I also called Aetna and made sure I understand that they don't count savings coupon towards deductible.
But now I have a question, maybe I should have left it as is and need not go through the hassle of rebate request? Or what they show deductible being met is only an intermediate status and probably would be updated to actual deductible value once they get payment information from specialty pharmacy? Could anyone please help me understand this situation?
submitted by /u/teja891
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