Wellsense deductible

Hey everyone!

I have BMC Wellsense Health Plan. BMC uses Express Scripts for prescription medication.

My health plan reset on Oct 1st. On October 1st, I refilled a prescription for Stelara which is an at home self injection that I take once every 8 weeks. It is expensive medication but I have a copay/deductible assistance program that helps me pay for it.

On my express scripts account portal, it says that have used up my $2,000 deductible from the medication refilled on Oct 1st… but on my Wellsense Health Plan portal it says I have used $0 of my deductible. I called and confirmed that prescription medication should count towards my overall plan's deductible, but I talked to both Express Scripts and Wellsense and just as it says on the website, the Express Scripts rep said $2,000 was used up on my deductible and the Wellsense rep said $0 has been used up on my deductible.

My question I guess is how long should it take for my deductible information to update on my Wellsense account. Is this just a matter of information needing to be passed along between the two entities or is there something funky going on here. I want to make damn sure that my deductible has already been covered before I take care of a kidney stone… and also a colonoscopy that I need to confirm my Ulcerative Colitis is in remission. I do not want any surprise medical bills =P

Thank you to any one who has knowledge on the health insurance process. I've been dealing with chronic illness for 15 years now and insurance is still a mystery to me!

submitted by /u/PayIndividual1081
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