I'm Pretty Sure My Pharmacy Is Evil

in #lifelast year (edited)

The other day my insurance refused to cover my meds because the pharmacy had charged them too many times this month.  They've been reporting fake sales to my insurance provider (in other words, my pharmacy has been collecting insurance payouts for selling medications that they didn't really sell).  How do I know this?  One of the pharmacists explained it to me (just enough of an explanation for me to figure it out).  I just had to ask the right questions.  From what I can tell, here's how they've been doing it:

When a doctor calls in a prescription, the pharmacy automatically reports to the insurance that the prescription was picked up around the same time or day that it was called in, even if I didn't actually come in and pick it up that day.  That might seem like just a trivial computer glitch, but here's the kicker: if I show up a few days later (just late for whatever reason) then my insurance company won't pay for the prescription twice, and the pharmacy did who-knows-what to the first batch.  That leaves me out of luck unless I pay them the full price for the medicine directly (without insurance).  This isn't the first time something like this has happened with them, but I didn't understand what they were doing until recently.

Yesterday they told me that my insurance was refusing to cover my prescription, and that I had to pay the full price for the medication without my insurance company's help.  That's when I started to piece it together.  I asked them how long ago they last filled that prescription, and how much they had given me.  They said that it was 2 weeks ago for a 9 day supply.  I asked them again why my insurance wouldn't cover it, and they said it was because they won't pay for taking too many pills too fast; apparently my insurance must think I'm some kind of pill-head.  The pharmacist looked me right in the eyes and apologized with a straight face, they must think I'm some kind of idiot.  Their math didn't add up at all, it didn't even make sense.  But I really didn't want to go without that medicine, it's vital to me.

So I paid the full price.  What else could I do?  Even though it didn't bankrupt me like it easily could have, it still sucked.  If my pharmacy is reporting fake sales and doubling-up their payouts like that then they're basically committing insurance fraud, right?  They're not just nickle-and-dimming me, they're going way beyond that.  I just don't know what to do about it.  What would you do?  Please take a moment and write your comment below.



Contact your insurance company, your state pharmacy board, and your state FDA offices. These organizations provide oversight and regulations of pharmacies and pharmacy practices. It couldn't hurt to contact the Better Business Bureau as well.

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Oh my!!! That’s not ok... It’s hard to trust anyone when these things happen! :(

Ask the insurance company to email you your records and tell them which orders you want to dispute. Send them the receipts of the ones you bought. Then they will ask the pharmacy for some sort of proof that they delivered them to you which they will fail to reproducing probably.

I think your claims will be believed more than those of the pharmacy as you have no incentive to lie about this. In fact the, you should be rewarded by the insurance company and compensated.

Thank you, that's a really good idea.

Medicine prices are spiralling out of control!

I would use a different pharmacy. Hopefully a pharmacy with low to no complaints on them with the Better Business Bureau.

You cant trust these people they are evil holistic doctors is the way foward im trying to go vegan and get of the meat fhey are even modifying fruits and vegetables don't worry things will change soon rise of the decentralised system

As someone who has a Pharmacist degree (but never done the job due to the moral reasons) I would suggest that you try to find some more alternative ways of treating your medical conditions. There is a lot of plants and plant mixtures in nature that can help us relive our troubles, without taking expensive pills that we even don't know what are they really made of. Also, positive thinking and regular exercise :)

Thank you, that's a good point.

Plz help me i am a new user plz follwo me

This is illegal. You should report the pharmacy to your insurance company as insurance fraud.

The pharmaceutical industry is already a fraud in itself. So with these kind of events even more fraudulent becomes

Of course it is. It's proven...

To be honest this is not surprising. I always said that if pharmacies and doctors run a straight business they will be out of business or make just enough to make it for the month. In any case I'm assuming you are talking about US therefore I suggest you pick up your meds immediately and request a statement from your insurance and report what is extra. That's your only way not to get screwed by the system

hi anomly, it looks like you are a person who is too stingy with votes or comments for you to give to others, why is that so please explain to me. :)

Hi, I'm sorry if you feel that way. But the truth is that I actually vote a lot. Have a look at my statistics at https://steemd.com/@anomaly
If you're concerned with why I tend to vote at 1% it's because I give so many upvotes. The way Steem works, if I voted at 100% then I would run out of Voting Power and I wouldn't be able to vote nearly as often as I like.
I would love to vote at 100% all the time, and when I vote at 1% I don't mean any disrespect, it's really because Steem only allows a certain amount of Voting Power.
Steem makes me choose between voting more percent, or voting more often. So I chose to vote more often.
I apologize for not commenting when I vote. I don't always know what to say and I feel a little shy sometimes. I mostly just prefer to vote.
Thank you for your feedback, I'll try to consider commenting more often. I hope this explains.

This was enlightening. How do you know what percentage you are voting at? I've been upvoting willy-nilly.

Once you get somewhere around 500 Steem Power or more in your wallet then SteemIt will start showing you something called The Slider whenever you vote. It'll pop-up when you click the vote button to let you choose the percent you want to vote with.
Personally I wish they would let everyone use the Slider, but that's just the way the folks in charge designed Steem to work.

I use SteemPeak, and they do actually let you use the slider, which is pretty useful, I have to say!

Hi. Have you checked out goodrx? https://www.goodrx.com

I’ve used it to find the best prices on filling a prescription. I’d report the pharmacy if they are up to funny business, it will hurt real people in need of medicine.


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Thank you, actually one of the first things I did when I got home that day was to order a goodrx card. It took a while to arrive, but they let me print out a temporary card in the mean time.

Call the insurance company and tell them you story, prove the recipes. If they still don’t fix the problems,then choose another.

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You’re a smart guy , I can feel it because I have the same detective feeling.

You should call your insurance and request their rules to know exactly what they are telling you about the number of pills. In case you discover the pharmacy is doing fraud, do not think twice:

Call the police. Or go to a police department

Can you use a different pharmacy? Are you in the US? Have you talked to your insurance company? Is it possible that they have been erroneously charging your insurance for snother person's prescription?

Ya I run into the same problem every month. I take two different things for anxiety so everytime I go to get them filled they have to call my insurance company to fill my Xanax and Valium. Just because they are both Benzos

"Arr ye up fur th' romance Lassie?" 🤨 -Keptin

Seems more like reckless business practices than evil "Big Pharma" to me!

Wow that's really enraging, hope you figured out a way to deal with this situation

Jeff Berwick on the dollar vigilante podcast talks a lot about big pharma and how it’s really taking people’s money and making them sick. The whole thing is a huge scam. They lobby governments to allow them to get away with it. The even have a part in the US occupation of Afghanistan as they profit from control of the opium fields.

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