MRG
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
- Joined
- Apr 9, 2013
- Messages
- 11,078
I've been receiving my copays returned from my PCP and other DRs for last 3 visits. Calling BCBS I'm at my max OOP for the year($2000).
But I'm still paying my copays for pharmacy benefits. Called Blue last week the first gal said there is only one max OOP, once you hit it your done for the year(assuming in network coverage and covered expense). She checked my medical and I've meet my max OOP. I can see that too.
When I talked with another Blue rep regarding pharmacy benefits she claims I'm $20 short of max OOP. I can't find what she's looking at(different system) Couple calls later she's escalated this to someone to research. First callback we rehashed that medical benefits says different totals than pharmacy benefits, she agrees they should be the same. Still waiting for next callback.
So my question is what have I missed? All DR. visits have been in plan for covered services. The same is true for pharmacy services. Anyone else had this happen? Thanks for any ideas.
But I'm still paying my copays for pharmacy benefits. Called Blue last week the first gal said there is only one max OOP, once you hit it your done for the year(assuming in network coverage and covered expense). She checked my medical and I've meet my max OOP. I can see that too.
When I talked with another Blue rep regarding pharmacy benefits she claims I'm $20 short of max OOP. I can't find what she's looking at(different system) Couple calls later she's escalated this to someone to research. First callback we rehashed that medical benefits says different totals than pharmacy benefits, she agrees they should be the same. Still waiting for next callback.
So my question is what have I missed? All DR. visits have been in plan for covered services. The same is true for pharmacy services. Anyone else had this happen? Thanks for any ideas.