During a period where my health insurance SAG AFTRA Health Plan was inactive (due to a clerical error), I had to pay for my birth control out of pocket at the CVS. I was charged $209.99.

I was reassured by the CVS clerk that I would be reimbursed once my insurance was back online and I brought in the receipt.

That did not happen. They only handle claims 7-14days.

After constant back and forth & lots of misinformation SAG AFTRA HEALTHPLAN finally told me to contact CVS Caremark.

CVS Caremark then only reimbursed me for $35.43 stating the following:

“Anytime you purchase a prescription without using your prescription insurance, the pharmacy can charge additional taxes and fees beyond your plan's contracted rate. Please keep in mind any additional fees or charges that exceed the contracted rate under your benefit plan are not eligible for reimbursement.

According to our records, the paper claim you submitted showed the total charge of $209.99. Under your plan, the contracted rate for this medication was $35.43.”

The CVS did not overcharge me tho. That’s just the price minus insurance.

What do I do? They refuse to reimburse me more. And the CVS refuses to help because they say they can’t after 14 days even tho they left that part out when they took my money.

HELP PLEASE.

submitted by /u/MonkeyRoad22
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