@@Scavenger82 I just started paying for my medications out of pocket. I consider it paying for the convenience of never having to speak with anyone from Express Scripts again.
@@noahfense oh my gosh! Express scripts sent me all 3 of my future refills for a topical medication when i only needed 1 refill so 3 tubes expired since i couldn't use up my other one fast enough🤬
I My partner and I used Exact Care. I finally decluttered the excess amount of his meds and dropped off at pharmacy that helps very poor. Otherwise they would have expired.
Retail pharmacist chiming in. Years ago my wife was enduring the same situation. She very sweetly and patiently continued to decline their "convenient service". Eventually she was pushed too far and declared, "well I'm currently sleeping with my pharmacist so unless that's a service Optum is prepared to provide, I'll be staying with my current pharmacy." She never heard from them again.
The good thing is that United Healthcare Guy is so hungry for money, you could lead him away into a nice, thick forest, far away from you, using a trail of quarters.
The only unrealistic part of this was that United Healthcare Guy didn't immediately try to force the door open once he could physically see the 20$ bill.
So relatable. I work at an independent pharmacy and every day we have patients who are forced to use mail order or go to other retail pharmacies by their insurance. The work of retail pharmacists is severely under appreciated, especially when you can have ones who will actually get to know you and your disease states. Healthcare in the US is so beyond insane, it just feels unfixable. There are too many problems.
As a former customer of an independent pharmacy until my insurance decided only certain chain pharmacies can fill prescriptions (and not even WalMart or Sam's so sorry for people who only have that as an easy option), OR we can have our Scripts delivered Expressly, thank you for all you do.
Definitely thank you real pharmacists, I don’t trust mail order thanks to needing a pharmacist to go argue with doctors and dentists to remind them I’m allergic to amoxicillin, despite me telling them three times before I left, including while on heavy sedation and anaesthesia (lidocaine only works if it’s enough to get me high thanks to genetics). Or reminding the doctor that they just prescribed a med that has a major interaction with another med they also prescribed. 😂
I go to my independent pharmacy because they have chairs and a table to sit at if there is a line. Which may be 2 people long. I was using Walmart and switched in the pandemic, because, even then, the line was horrendous. And, at the little pharmacy I can get a Peach Fanta.
I’ve never used a mail pharmacy ever, until recent. I was told that my manufacturer’s coupon would cover the cost fully. NINE MONTHS LATER I got a bill for HUNDREDS OF DOLLARS. One dose of medicine, that I never used (still in my fridge) and when I called they gave me the run around. Told me to “call back in a week, we need time to figure out what happened.” The next day I got a message saying my next dose was on the way?!?!? What?!? NO!! Absolutely, positively NEVER AGAIN!!!
@@d.f.4918 NOOO never never never sign up with Walgreens ever, it's a nightmare, I spent literally hours cry-screaming at people on the phone to try to get them to cancel things I never approved
Thank God in Europe we can legally get out of any unsolicited orders. If they ship you something and claim you ordered it, you can in turn claim a failure in transmission or process and return it / deny payment. In the US I get the sense that they'd kidnap you and force-feed you the meds if that means they can afterwards bill you for them
As a fedex driver who sometimes delivers those optium boxes, I want you to know those boxes have seen horrors beyond comprehension. Well that tempeture extremes, being crushed, and jiggled around a lot.
I'm sure of it! In our part of country we can have over 100 degree heat or minus 40 cold, that's a huge variation. Nevermind delays due to weather which could occur anywhere!
I'm a hospital pharmacist; one of my favorite mail order pharmacy fiascos I've ever had to deal with was on a discharge review, where I had to spend 3 hours of my workday muddling through multiple phone calls while getting the runaround from Humana's mail order service trying to get a patient's Keppra paid for. They were just being started on it for the first time, and Humana wouldn't let the patient fill a short supply at our hospital pharmacy, even though it would take upwards of 3 days for the Keppra to come in the mail so the patient could take it. Delayed the patient's discharge from the hospital that day to ~5pm. I have a ton more terrible mail order pharmacy stories, as I'm sure nearly every pharmacist does, but this one has always stuck out to me as the most infuriating.
I used to work for United Healthcare. The higher up in management you look, the less they care about people's health. And there is so much political infighting between different teams, that you can hardy call it united. They should change the name to Divided Health Apathy.
You can pry my grocery store pharmacy from my cold, dead hands. Seriously, I love my pharmacists. Sarah and Jorid are amazing and super helpful and when I move out of my current place I'll probably keep going there even if it's super inconvenient. Also I'm on a Schedule II medication for ADHD which I'm pretty sure I wouldn't be able to do mail-order for, and even if I could I wouldn't bc I'd be afraid of someone stealing it from my mailbox.
Oh, its far worse than that. I take a schedule II; the insurance still makes you do it via mail order, but you can only send the prescription to them when you're almost out, and each month it takes 2 to 3 weeks to process the order for it to arrive. Imagine being without your medications for almost a month.
The mail order pharmacy will send it, but it has to be signed for by an adult - and that adult must have their ID available. Too bad if they try to deliver while you aren’t there…
@@teh_dav2179 there have been numerous news stories about a shortage of Adderall, so if that's it, that would explain why it has been taken so long. They can't fill what they don't have in stock.
@@teh_dav2179 I am almost in this situation with my new heart meds-- not a controlled substance (if you use too much your heart would just forget what electricity is, so... not really something recreationally viable) but I struggled to find a pharmacy who would actually order it without screwing up the order or freaking out about the physician authorization -- my cardiologist's office was deeply confused by it, as was I, because for once the insurance company got back to us so quickly I actually got _double_ confirmation notices in the mail. My current grocery store pharmacy, the only one that actually managed to get my medication for me at all, messes up my medication every month; frequently doesn't stock it and has to order it in late/give me a partial refill; has a trainee that works late who will habitually input my information wrong and then snap at me for pointing out that _I do kind of need 60 pills_ for a 30 day supply of a 2x daily medication and can't really afford to pay full price TWICE just because he didn't order the full amount of the medication in AGAIN, and therefore only had five pills to give me, but just charged me for the full 60 pills....which I promptly return then and there so I can actually afford the full amount when it comes in. I just want the thing that keeps my heart from beating too fast, man. I am at the point of sometimes skipping doses strategically because I know I won't get more until potentially a week after I run out, because if I call early they screw up the order, and if I call later the order's late. I cannot imagine if that took three weeks; I would probably just resort to driving to the hospital and filling all my medications there, maybe, cost be damned? Scary to think about...
I am new to the US and I thought that I was crazy because this was happening to me, and it is crazy, but I have never heard anyone complain about it. So I had started to think that I did something wrong. Maybe I needed to check a certain box, or call a certain number. It turns out, I was being gaslighted by this crazy system. Thank you, Dr. Glaucomflecken. P.S: Am I the only one who constantly gets their voicemail spammed by automatic messages (well, 3/4 of the message, since they start the verbal barrage without waiting for the beep): "...edication is ready. If you want to receive it at home and pay less visit..."
If the message comes from your pharmacy you can ask to not receive those calls when you pick up your next prescription; if it comes from your insurance company you can ask to not receive those calls by calling customer service or asking to stop them if an actual human calls you. I used to get "helpful reminder calls" from my insurance company if I didn't fill a few key medications a week before the refill date on the bottle, and if I ignored the call for a while and finally answered after my medication was supposed to have run out they would always press me as to why I hadn't filled it yet and if I had enough medicine. Yeah, my doctor appointment didn't quite synch up with my refill schedule so I had a few extra weeks worth. "Oh...Do you want us to call your pharmacy right now and connect you so that you can refill it? It's no charge and we'll connect you directly to the pharmacy team." No, I'm good. Oh, and can I stop getting these calls please? They're pretty annoying. "Sure. At ____ we want our focus to be on you."(or something equally cheesy).
@@Sashazur Oh for sure. We owned a small independent pharmacy for 20 years and I cannot believe the change we saw in that time. It seemed like even if there were lobbyists who were "on our side", they were NEVER on our side.
Also, consultation at pharmacies is so important. Don't get me wrong, my doctor does a great job, but most of the medications I use are rotated on a monthly basis, meaning it's sometimes weeks between talking to my doctor and going to pick up the medication. I cannot tell you how invaluable my pharmacists have been in reminding me when and how to use the medications, how to store them, etc. I can't imagine that a mail-order pharmacy would have that same level of caution and helpfulness.
Don't expect much counseling if you go to a CVS or Walgreens either. They've shrunk their employee hours down so much that the staff just plain don't have time to talk to you.
@@falconerd343 more like they cannot find enough employees to hire. Pharmacists and Pharmacy Techs are in high demand, at least in some parts of the US.
@@Rosarium2007 its not a staffing problem, its a wage problem. Theyre being paid peanuts but required to have degrees and are far too overbooked. Even when they are not understaffed places like Walgreens will only give them the hours for the bare minimum staff and expect them to do a full staffs worth of work.
This video came at the perfect time, when UHC decided not to pay for a refill on a medication I haven't changed or had any issues with since it was prescribed years ago until a week after I was gonna run out. I can't sleep and I'm paranoid, nauseous, and depressed. Thanks for protecting my health, UHC. I love it.
I went with the mail order pharmacy for a couple weeks after starting a new job. I'm chronically ill so the box was always huge, and they also always sent half a dictionary in terms of medication dosage and side effect information. And then one day I opened up the big box they sent and found some extra paperwork--someone else's sheets, on top of mine. It had this person's full name. The names of their meds, and the dosages, and the disorders they treat. Their home address. Phone number. Medical record number. HIPPA violation backwards, forwards, and through several walls. Closed my account with them that day.
That sounds like the start of some kind of dystopian story. Oh wait, it's just another day in the US. Did you contact the other person to let them know what happened?
I moved from a small town to a big city.I miss my old, non-chain pharmacy so much. Virtually never a wait time on the phone, they were always happy to answer questions, they caught it a couple of times when a doctor prescribed something I couldn’t actually take. Man. Those were the days.
As a kid of two pharmacists, please allow me to shake my fist in fury...okay, we're in a different country, but screw mail order pharmacies. Consultation is also important, and has to be always available, damn it.
Here in Sweden we have pharmacy chains where you can choose to physically go to a pharmacy if you need a consultation. If you know what you need you can just log in to their website with your online ID credentials and order what you need, shipped right to your door, or nearest post office. Which is really convenient for me as a liver transplant recipient 10 years post op. I know what I need and how to take it haha.
Question from Germany: Do different Pharmacies in the US have different prices for the same thing? (Like, say, Ibuprofen from the same manufacturer in the same strength, with the same brand name).
@@RevCode Oh for sure, we don't have pricing regulations for anything. Ibuprofen is over the counter, but pricing on everything is going to be different even between different stores in the same chain
@@nicolainielsen7700 My parents actually did deliveries as well, usually for elderly patients, or those who had trouble getting around (especially in the countryside). Either in the evening or after closing, one of them would take the car and drive to the nearby villages around the pharmacy, bring our costumers their medication and such. When I still lived with my parents, I helped too, going to everyone I could reach with my bike and later my first car.
You hit the nail right on the head! Mail order pharmacy is designed to benefit the pharmacy first, the patient second. It works if it's connected to a physical chain, but its just not enough. Can't wait for the investigations to cut these vertical monopolies down!
If I ever get past Dr. Glaucomflecken's (Dr. William Flanary's) super entertaining presentations, I realize that his acting is incredibly thorough and his creativity and humor is top drawer. I've seen all his videos, multiple times, and more. He has helped me get a handle on the health care industry and see it from an inside view. Very revealing.
That probably depends on the contract with the pharmacy. There is probably another pharmacy where United will pay the whole cost of administration, but the patient may have to call United to find out where.
United WILL cover a flu shot but you have to be absolutely certain to space every 2 immunizations you need out per year. Which means your flu shot will always be cash payment or full price, even with the highest band of coverage UHC offers. I HATE THEM. Their dental care sucks, their medical insurance sucks, if they offered house, car, or life insurance, I'd sooner grate my face off than use their services ever again. They are technically the cheapest insurance carrier in the U.S but that cheapness comes at a price. They overcharge you relative to the services you have to gouge them in the eye balls to provide. (Even when it's covered and the clueless Health Insurance Rep. claims that it "isn't covered by your plan".) Ask me how many times I have sat on the phone for hours to get something covered by them.
This exact thing happened to me except they put a block on getting it from my local pharmacy. I had to call and have them undo the block just so I could *order* from my pharmacy... They said they do that for all customers who hadn't ordered through Optum. Thanks for calling these companies on their BS!
I mean, surely this has to be against anti-trust laws. There’s no real difference between this and railroads giving unfair rebates to Standard Oil. The Sherman Antitrust Act hasn’t been used in a while but I think it could make a comeback
It could... but the state of influence that the mega wealthy had and the horrific history of the Supreme Court on ANY case involving the mega rich (seriously look it up I think the Supreme Court has sided with wealthy side on financial cases 100% of the time) meaning we would need some real reform before we can curtail their constant consolidation and amassing of all the capital.
I work in a specialty pharmacy for a university hospital and we have to tell all the UHC patients they have to fill through Optum Specialty instead of us. Without fail, they always contact the clinic pharmacist a few months later complaining about Optum Specialty and asking what they can do to fill with us.
Yeah, this was me and CVS Caremark too. "Oh your pharmacy coverage put a hold on this, they say you're supposed to do the mail order?" "Ugh, hang on, I'll go yell at them, AGAIN."
I feel this in my soul. I used to be on Medicaid and always got 90 day prescriptions from my local pharmacy no problem. Got on Caremark last year and they cut it to either 30 day prescriptions in store or 90 through mail order. I switched over and sure, I still get the 90 days, but only over a week after I run out of essential everyday medication. Every single time. So helpful... Ugh...
Factual. Pharmacist here. My insurance is basically telling me my pharmacy is out of network and where I should get it filled. You, as a Patient, have a choice . Please never forget that.
Successful medical practice, versatile acting and writing talent, family man, highly popular RUclips channel, insightful and incisive political commentator....Amazing. May you go from strength to strength!
I'm forced to use Accredo by BCBS and this is basically my experience. It's essentially destroyed my health because they're so incompetent. There was a period of literally several months where they could not fill my prescription and they couldn't figure out why, and after that, when that got "resolved," it took over a week for them to get pharmacy approval (??? not prior auth, but something else??) so I could order it. They also always ask me why I don't fill my prescriptions online or using text, but they never send texts and when I try to fill online, it says I have to call. Thanks to all of the delays in getting my meds, I'm actually extremely ill and disabled because my meds stopped working. :) awesome
Cant you apply for medicaid or medicare since your disabled? You wont have to deal with that nonsense anymore if you get approved for it. Im a college student and i work, i was able to apply for medicaid for myself and my child and i have the option to use it their mail order pharmacy called cvs caremark , but i dont. I prefer to get my meds to an actual regular store pharmacy and medicaid always pays for it.
We just experienced this with a different insurance company. We went to pick up my husband's meds and instead of the usual $10 no matter what we were picking up, it was $90. I called the insurance and they said if we want a cheaper price, we must use their mail pharmacy. How much cheaper? $30 "My kid is on Keppra for seizures. I'm not doing that." "Well, just switch everything else to mail order and pay more for the necessary stuff." "And what do I do when my local pharmacy closes because you moved all their customers to mail order since my employer is the largest in the region?" "You'll pay less if you do the mail order." "Can you even legally mail some of my kid's medications?" "I don't know but you can try it and find out." "That would literally risk killing my kid. I know it isn't your fault lady, but you are working for monsters."
Ugh, once when I was sick as a teen the "preferred" pharmacy was out of my meds. So was the next closest in that chain, and the next and the next and the ne...... The closest pharmacy in that chain was 150 miles away. Or a different pharmacy 2 miles down the road had it. My mother was out of town and my father was trying to reason with the health insurance rep on the phone that leaving his sick kid home alone for over 6 hours wasn't an option. It ended up "only" being about $100 so he ended up just paying out of pocket. Complete and utter bullshit.
Reminds me of an experience I had with CVS. Constantly calling, spamming and emailing begging to go with their mail in system. The CVS store is less than half a mile, the drug is common with a $2 price tag for a 30 day supply. They were honestly trying to woo me with saving 25 cents. I just couldn't believe the effort they were putting forth for so tiny revenue. Gave up on CVS as a result of the experience.
So accurate! I use a specialty med that has to come from a mail order CVS. They cannot - absolutely cannot - ever get it correct, month after month. Not only that, CVS bought out my local independent pharmacy (0.5 miles away) and closed them down. So now I have a 7 mile drive to the next nearest pharmacy.
Insurance: Use our mail order pharmacy for your Schedule II controlled substance prescription! We'll send you a 90 day supply! Me: A 90 day supply? For a controlled substance? That my doctor has to prescribe as 3 separate 1-month scripts with no refills? And only the pandemic allowed me to stop needing to physically carry the script with me to the pharmacy? Insurance: Yes! You can fill that with our mail order pharmacy :) Doctor: It's literally illegal
MDs in the US (unless there is some state law to the contrary in your state) do have the discretion to write 90-day scripts (some drugs are 84 days) for Schedule II drugs. They might have extra paperwork or such or be limited in the number of patients they can do it for, I'm not sure of the fine print details, but they can do three month supplies. Three months later they have to send a new script to the pharmacy for the next three months. Wash, rinse, repeat.
@@Sb_747 not quite - there are pockets available elsewhere. Problem is finding where. The fact they’ve stockpiled is a real problem though - especially for patients with Caremark/CVS prescription coverage. For some reason CVS really doesn’t have any sense of humor about patients using OptumRx.
@@Rosarium2007Florida has gotten really hinky about controlled substances. And my sister has to take her husband to the doctor EVERY MONTH to get a new prescription for the oxycodone he's been taking for years for a shoulder replacement that has never been pain free.
Might depend on your state. In mine, we can dispense up to 90 days of a C-2, it's just that most insurance will only cover 30, so we do the multiple scripts thing. Also, doctors will only prescribe that much at a time when they're sure it won't be abused
SO TRUE! They will just annoy you into using their mail order. We have a large local company whose insurance plan will only pay for 21 days at a time. Such a pain for everyone involved, patients, pharmacies, and doctors. Ignore the fact that study after study shows that 90 day supplies lead to better health outcomes and better adherence. Nope, getting the profit is most important.
WOW !!!! Incredible how honest and accurate this is. As an ER doctor I deal with lots of people and see the impact Heath insurance have on the patients. STAY SAFE ALL !
My mom who due to multiple complicated chronic illnesses has a whole drawer full of daily and weekly prescription meds. My family didn't have a car, and my dad walked to the pharmacy a mile and a half away once or twice a month for her meds. For the first time in a decade the pharmacy messed up. They had just implemented a system where the pharmacy had some meds filled off site and sent to the pharmacy for pick up. It was a medication that if my mom had blindly took it would have messed up her blood pressure big time. When my father called the pharmacy the lead pharmacist there listened, and told my dad not to worry (it had just snowed and the sidewalks were not clear yet) he would come with the correct medication around 4pm after he got off work. He did just that, apologized profusely, looked at the medication my mom got accidentally, and was relieved my mom hadn't taken it. United Healthcares bullshit system wouldn't have done that for her and my dad.
These people keep calling my mom every 6 months trying to get her to switch (even though our pharmacy is LITERALLY next door to her place), and it’s a headache every time. WE LIVE IN TEXAS. YOU CANNOT EXPECT INSULIN TO ARRIVE IN THE MAIL ANY TIME BETWEEN MARCH AND OCTOBER AND NOT BE RUINED BY HEAT. Def showing her this next time I go over 🤣
Spend a day or two on the phone with their customer service. Tell every representative that you speak with that you will sue them for harassment of your mother if they don't stop calling. It makes me furious that these companies are so greedy and have to take advantage of our elderly. I had to deal with the insurance for my husband's grandma for a long time, it was a headache all the time. Good luck!
Omg! I love this ! I tried Optum Rx… it’s horrible… and I’m being nice when I say that! It seems like it should be illegal to be charged more for going elsewhere, but it’s an insurance company with well paid lobbyists so they get a pass. If a Dr charged the insurance company more than self paying patients … watch out!!
I had to use a mail order pharmacy while I was on Blue Cross/Blue Shield of Oklahoma. I take a crap ton of meds, so you can imagine how large that bag of 90 days worth of meds was, just hanging out of my little mailbox that is visible from the street. And I live in a neighborhood with lots of elderly people. Nope, not intriguing to a thief at all. 🤦🏻♀️
The best part is that you actually don't have a choice if you have most employer plans. Usually only 1 fill is covered in the pharmacy and all refills required mail-order. Some plans allow you to *try* and opt out of mail order but it requires you to call and then be put on hold for about 3 hours as they transfer you to about 10 different reps. And then you find out you are using a non-preferred pharmacy so your aspirin that was free is suddenly $15 copay. Brand name drugs? You pay 100% of it +$15 extra out of pocket for the medication but suddenly the copay is $3 if you go into mail order.
100% truth. My insurance doesn’t even give me an option. I have one mail pharmacy choice and if you don’t use it, they don’t cover anything. Not even generics. I have lots of nasty allergies and they are supposed to be following a procedural checklist to keep me safe. I literally had to submit safety violations to my state on every refill last year. It didn’t change anything. So my personal mission this year has been to cause my insurance extra expense. In this case, the insurance and pharmacy are the same company. Every time they send it out without the checklist, I call. They try to reassure me that it was done and I state that if it isn’t in writing in my package, it never happened and my meds aren’t safe to take. They have to resend (at their expense) all my meds. I thought it would only take one time doing this considering my meds cost about $4500/month. They screw it up every month despite assuring me it won’t happen again. It is my personal mission to hit them in the pocketbooks until they either get better or give us another option.
As a medical billing a/r specialist (aka I work all the denials these sea monkey brained insurance companies create), optum is the actual bane of my existence. An actual scenario i had a few weeks ago: "Oh, your office got a prior auth from United, but your patients pcp is an optumcare physician? Then the Auth is no good. Yes, Optum owns United. Yes, the patients card says united. But our eligibility portal says that the patients pcp is with optumcare, so you should have gotten an auth with optumcare. You're not the pcp office? Still, your United auth is no good for this patient. You can try to appeal that if you'd like."
They basically impersonated Humana with my 78 year old mother over the phone and made an appt with her for a "house call". The only way she figured out they Weren't Humana was when they gave her a coaster set that said United Healthcare. She was PISSED! She called Humana and they said they've had alot of calls about them and that United was trying to poach customers!
@@ghiansudelo2590 did you read the op post? She never said she wanted to switch to united health care. She said united health care lied about who they were when phoning her, stating that they were instead another insurance company called humana
It's a nightmare with mail order pharmacies. As a retail pharmacy tech, the amount of arguing we have to deal with from mail orders for transfers is awful.
"We promise we won't give you medication that just looks like yours. It won't be dangerous we promise! Just so you know our promise is not a guarantee."
As someone on ozempic a medication that needs to be refrigerated , I felt this in my soul. $95 for an in store pick up, or $5 delivery with the hopes optum messages me on time with the pick up.
Ahhh, yes, mail order. The second thing retail pharmacies hate the most, after prior authorizations. Nothing like telling a patient who just brought in RXs from the Emergency Room "Sorry, your insurance thinks you can wait a week for that blood thinner for your lung clot."
When I worked for CVS people would get so mad at us for their insurance forcing them to use a mail order, like we could override it so that they could use us.. sigh.
So accurate, I use to know a guy who almost died several times because of these guys. He had a medicine his life literally depended on and they were late delivering it several times once they even sent the wrong meds and refused to send the correct ones because their system said they already sent him his meds. He couldn't get them from a local pharmacy because his copay was way too high. It was bad he ended up quitting his job and getting a new one just to get better health insurance.
My insurance company sent me things for months trying to get me to use their mail order pharmacy and I was finally given an option to tell them to stop sending me ads. I had no idea United Healthcare was doing this to their customers, I'm grateful that the worst I had was a bunch of junk mail and some emails and texts
I recently used a non-coerced localish mail order pharmacy and the service has been great. Wonderful customer service, overnight shipping, cost is 10x less than the local chain pharmacy.
I've never had any chance to get attached to any particular pharmacy, and luckily my experience with mail-order (which goes through the same organization I get my healthcare through, so I'd most likely use their in-house pharmacy anyway if it weren't being mailed to me) has been positive. It pretty much always arrives faster than predicted (it estimates 3-5 days, but I usually have it in 2), I have yet to be sent a wrong prescription, I get a delivery notice, and I don't have to pay for shipping unless I want next-day delivery. It's gone pretty well for me so far. I always get my first fill at the in-house pharmacy, though. Mail-order still has the info sheet, but no person to explain any of the important points or ask questions. Plus, when I'm prescribed something, I'm generally, y'know... already there in the building, so I can grab it same-day before I go, and just do my refills mail-order.
Internal medicine doc here. Your posts absolutely nail that's rotten about the business of medicine. They make me laugh and p--- me off (not at you) at the same time!
@@Sashazur the few times I've done it it was prescriptions from the pharmacy of a Kroger and if someone isn't home I just brought it back to the pharmacy
Sad part is many people need to resort to asking for meds cash.Unfortunately, some medications are cheaper paying cash than going through an insurance and paying a copay... defeating the purpose of even having insurance in the first place.
I had a magnificent piano, lovingly restored inside and out. Had to sell it to pay for daughter's meds. Every year on January 1st we have to start paying completely out of pocket for every thing medical. Yes we keep that in mind when planning christmas, heck i had January's medical bils in mind every fall when we stocked up on sales, because in january we spent the grocery money on medical stuff. But that year was extra hard. I still miss that piano.
United Healthcare won't let my wife get her antidepressants filled at our local CVS. It took them 6 months to finally mail us her prescription, while my wife was suffering from Postpartum depression.
I have United through work for medical, but we don't use their pharmacy coverage, we have a separate pharmacy plan. I had wondered why. Now I know. My employer, amongst other things, owns a mail order pharmacy (and a whole lot of retail pharmacy locations). And for the question on temperature - medications requiring refrigeration are shipped specially packaged to keep them cold and for medications that can be damaged by warm temperatures, during the warm part of the year those are packaged in insulated bags designed to keep the heat out. And the packaging is very nondescript. Edited to add: I haven't read all 442 comments, but I read a lot of them and the pharmacy my employer owns hasn't been mentioned. Also, if you want job security go train to be a pharmacist or pharmacy tech. There is a shortage in the US. Has been for years. 2020 just made it worse.
We had to go with their mail pharmacy, unfortunately. Going to our local Rx, resulted in being approved only for a 30 day supply each time and higher out of pocket cost. We are older folks and raising a younger child. We didn't have the time or money to keep using our Rx. Frustrating.
Totally agree with the heat issue. It's in a hot mail delivery truck all day and then a hot mail box. I know it has semi crumbled for some people. Not worth it unless you are in a very rural area.
Let me at least smell it (stiffs through the door crack) this is beyond genius and legendarily hilarious so much so that my family has banned me from watching Dr.Glaucomflecken after a certain time because ill start cackling out loud and wake everyone and the dog up
As a 2nd year pharmacy student, I can confirm this development in retail pharmacy. This branch will be pushed away by online shops in the future sadly. That is also the reason why our teachers begin to train us in working at the hospital and why clinical pharmacy is on the rise. I really hope to become a good pharmacist one day, but what I wish even more is to succeed in a hospital work environment since a bunch of doctors I know who all have high working positions at the hospital are now quitting and saying how horrible it has become since the pandemic
I highly recommend placing in a residency then... Hospital jobs are pretty competitive right now, and usually you need to know somebody and get a good recommendation to get into a decent hospital job. Though at the hospital I work at all our residents get preferred treatment. Meaning, if you do a residency with us, we are going to try and hire you. Though, be prepared because pay will not be as good as in retail. Sometimes 10-20k less than starting at a retail position. Still, personally, CVS/WAG could not pay me enough to deal with the amount of crap retail pharmacists do on the daily.
@@oxnyxws same day shipping is a thing already I’m not so certain that the desire to start medications immediately will prevent it from becoming online dominated.
Because of my medical condition I do appreciate being able to get my medications mailed to me, but I very much value by local pharmacy. I'm going to start start getting my prescriptions delivered from my local pharmacy.
This vignette is spot on correct. Due to their "financial coercion" tactics, I refer to my mail order pharmacy as "the PharMafia." Also spot on: "Q: How's your customer service? A: Terrible." No matter how wrong they might be-sending the right medication with the wrong dosage, calling my doctor for authorization when there are multiple refills remaining, charging the wrong copay, etc.-they will never, ever admit to being in the wrong or making a mistake.
You didn't mention how next month you go to your community pharmacy, but they can't fill your meds because they get a rejected saying it's been filled elsewhere. You swear to them you haven't gone anywhere. Here starts a long investigation of trying to figure out what that other pharmacy is so you can call them and have it reversed only to find out it's a mail order pharmacy that already sent out your meds so they cannot reverse the claim and you're to be getting your meds in 1-7 days 🙃
Can you take them to small claims court over that? Demand compensation for any difference in price, for the delay in getting your meds relative to when you went to buy them, for the emotional damage of worrying that you wouldnt be able to get your meds because they fraudulently claimed your prescription without informing you, for the time you wasted finding out what had happened, for defrauding you by selling you goods without your consent, and for the time you have to waste going to court over it. Should be able to get at least a few hundred dollars without needing to hire a lawyer.
@@SovietReunionYT The thing is, in such a scenario that’s kind of the prescriber’s fault for sending the prescription to the wrong pharmacy first. If we change pharmacy practice so that billing cannot be done before contact with the patient for every fill of every prescription, wait times for prescriptions are going to get a lot longer very quickly… Maybe that’s what we want to do, but at least be aware of the trade-off we’d be making if we choose to go that route.
@@KirisutonoNeko Medical assistant here. Sometimes that happens when a patient asks for a refill but doesn't specify which pharmacy to send the medication to. Sometimes they have 2 or more pharmacies listed. They get mad at us in the office, but if I ask if they specified which pharmacy, the answer is usually no. We're not mind-readers, either. Medication requests done through automated phone or patient portal will default to the first pharmacy listed for the patient.
I actually like the invention of mail order pharmacy. But then I live in a country where there’s no penalty to it. It really is just an option, and in fact my insurance claim doesn’t cover the mail order prescription, and only covers the regular in-person prescription. When it’s applied in a non dysfunctional healthcare system, it’s great for getting simple OTC stuff so you don’t have to get out when you have the flu, and you can get things like travel meds without hitting up pharmacies only to find they’re out and have to go wandering to find one that has what you need. and of course, it only makes sense when medications are by default affordable, so you don’t mind paying for your own for convenience, rather than call upon your insurance cover.
Y'know, for someone who has hated doctors my entire life and has literally only ever had one good experience with a doctor of any sort, I JUMP when I see Dr. G's new video is out.
@@suemilkbone4868 it's all about rerouting money to insurers. Because the US is one of the most expensive systems in the world, and it doesn't have good, accessible care for all. If it was about using money for good health care, stay the hell away from the US setup.
CVS Caremark literally won't cover "maintenance" medications (aka any medication that is for a chronic condition) filled anywhere other than CVS. How it's allowed under the anti-kickback statues I'll never understand. Additionally they won't cover pill counts other than 90 day supplies because then CVS can just use the manufacturer's bottle instead of having to dispense it in a traditional orange pill bottle w/ the white cap.
oh man. I am a 4th-year pharmacy student. I will recommend mail-order pharmacy only as a last-ditch effort and only if pillbox packing isn't available where the patient lives. Sometimes, pillpacking is a literal lifesaver for patients with impaired cognition and complicated medication regimens. Many community pharmacies offer this service and I hope more will in the future so we can never recommend mail-order! I really hate how insurance companies are gaining monopolies over healthcare. It feels illegal!
Ha! My pharmacy charges $5 per medication to blister pack those fuckers. $5 per medication. My husband's medication blister packs are $90 a month. And they are making us pay for a robot to pack those blister packs. And we have to double check, and we're blind, that it's even been done correctly.
Because of your video, I did some research and I had no idea how horrible are these for profit companies monopolizing our healthcare system.... We have to stop this madness.
I have porch pirates that steal everything I order. After having to replace 3 boxes of meds, they decided to let me go back to the grocery store pharmacy. 😂
The pharmacy I use is literally a 30 minute drive away from my house because it's the closest human owned store that I could find that offers my medication. Dealing with _any_ chain pharmacy has been a hassle for me in recent years, but since this is a place owned by an actual person that actually gives a damn about my business, they're always absolutely perfect with everything I need
the hospitals I've worked for that I get my insurance through have actually made it so that my prescriptions aren't covered UNLESS I use their pharmacies. Either mail order or going in person to one of the hospital pharmacies if I want to go in person. The first hospital told us our ONLY choice was mail order and my medications ended up being 2 months late because they weren't prepared for the influx of customers even tho they were given a year's notice
I found a way to game the mail order pharmacy and the retail pharmacy into giving me my prescriptions refills early. Living in the sticks, this was useful as winter weather would sometimes mean no meds at the pharmacy and no mail. Always have a 6 month rotating stock of my epilepsy meds on hand
So happy to be a UK resident (although my mother was born in Utah), especially in Wales where prescriptions are free. I'm on almost ten medications and it costs me... Ditto. I'm lucky, I live within yards or 4 pharmacies, including a big independent one. I'm able to order my prescription from my GP surgery via the internet the and can collect it filled at local pharmacy (I choose the independent because they go the extra mile and have more staff than chain pharmacies, thus quicker) in less than 48 hrs... we have a lot of problems from underinvestment the last 12 years but the hellish stuff Dr G highlights isn't any of it thank heavens
oh boy. I get my antidepressants mailed. despite talking to my psych several time and getting the prescription sent in, its has been TWO MONTHS since I last had them. radio silence. two months since ive had my extremely-necessary-for-treating-my-very-severe-depression meds. so fun!
“Your medications almost always come on time and are frequently the correct ones” such a good line!
This is the exact reason I'm willing to pay more and suffer the "inconvenience" of going to get them.
@@Scavenger82 I just started paying for my medications out of pocket. I consider it paying for the convenience of never having to speak with anyone from Express Scripts again.
@@noahfense oh my gosh! Express scripts sent me all 3 of my future refills for a topical medication when i only needed 1 refill so 3 tubes expired since i couldn't use up my other one fast enough🤬
I My partner and I used Exact Care. I finally decluttered the excess amount of his meds and dropped off at pharmacy that helps very poor. Otherwise they would have expired.
That's what you call "damned by faint praise"!
Retail pharmacist chiming in. Years ago my wife was enduring the same situation. She very sweetly and patiently continued to decline their "convenient service". Eventually she was pushed too far and declared, "well I'm currently sleeping with my pharmacist so unless that's a service Optum is prepared to provide, I'll be staying with my current pharmacy." She never heard from them again.
Great comment - your wife is awesome!!
Im using that line ( even though it will be a lie) if they ever try to come for me, thats genius
Filling orders in more ways than one, am I right? *Sorry*.
Jesus I wish I could have said this when I called for my patients back in retail pharmacy.
Your wife is amazing!!!
The good thing is that United Healthcare Guy is so hungry for money, you could lead him away into a nice, thick forest, far away from you, using a trail of quarters.
This made me laugh so hard I snorted!
OMG....I have UH DC.....they would NOT leave me alone lol
What makes you think I have enough money to pull out enough quarters to get them far enough away from me? Lol
@@caidalee1994 Pennies then?
I actually have a whole bunch of money down in my wine cellar :)
don't mind the bricks
The only unrealistic part of this was that United Healthcare Guy didn't immediately try to force the door open once he could physically see the 20$ bill.
Lol, yeah, I was totally expecting him to go all rabid dog on that bill.
There like vampires they cant cross the threshold unless invited in
😁
So relatable. I work at an independent pharmacy and every day we have patients who are forced to use mail order or go to other retail pharmacies by their insurance. The work of retail pharmacists is severely under appreciated, especially when you can have ones who will actually get to know you and your disease states. Healthcare in the US is so beyond insane, it just feels unfixable. There are too many problems.
As a former customer of an independent pharmacy until my insurance decided only certain chain pharmacies can fill prescriptions (and not even WalMart or Sam's so sorry for people who only have that as an easy option), OR we can have our Scripts delivered Expressly, thank you for all you do.
Knowing diseases is not a pharmacist's job. They more often waste a doctor's time than do anything useful.
Definitely thank you real pharmacists, I don’t trust mail order thanks to needing a pharmacist to go argue with doctors and dentists to remind them I’m allergic to amoxicillin, despite me telling them three times before I left, including while on heavy sedation and anaesthesia (lidocaine only works if it’s enough to get me high thanks to genetics). Or reminding the doctor that they just prescribed a med that has a major interaction with another med they also prescribed. 😂
I go to my independent pharmacy because they have chairs and a table to sit at if there is a line. Which may be 2 people long. I was using Walmart and switched in the pandemic, because, even then, the line was horrendous. And, at the little pharmacy I can get a Peach Fanta.
@@sophierobinson2738 you can get peach fanta at your pharmacy? Damn, mine doesn't even have water plumbed into a water Dispenser.
I’ve never used a mail pharmacy ever, until recent. I was told that my manufacturer’s coupon would cover the cost fully. NINE MONTHS LATER I got a bill for HUNDREDS OF DOLLARS. One dose of medicine, that I never used (still in my fridge) and when I called they gave me the run around. Told me to “call back in a week, we need time to figure out what happened.” The next day I got a message saying my next dose was on the way?!?!? What?!? NO!! Absolutely, positively NEVER AGAIN!!!
I don't have a problem with my mail order prescriptions but then again I use Walgreens which is the same company as my local pharmacy.
@@d.f.4918 NOOO never never never sign up with Walgreens ever, it's a nightmare, I spent literally hours cry-screaming at people on the phone to try to get them to cancel things I never approved
@@litsci1877 I’ve had so many major issues with Walgreens and now I have to use them or mail order! I loved my local pharmacy!
Thank God in Europe we can legally get out of any unsolicited orders. If they ship you something and claim you ordered it, you can in turn claim a failure in transmission or process and return it / deny payment.
In the US I get the sense that they'd kidnap you and force-feed you the meds if that means they can afterwards bill you for them
As a fedex driver who sometimes delivers those optium boxes, I want you to know those boxes have seen horrors beyond comprehension. Well that tempeture extremes, being crushed, and jiggled around a lot.
I'm sure of it! In our part of country we can have over 100 degree heat or minus 40 cold, that's a huge variation. Nevermind delays due to weather which could occur anywhere!
I'm a hospital pharmacist; one of my favorite mail order pharmacy fiascos I've ever had to deal with was on a discharge review, where I had to spend 3 hours of my workday muddling through multiple phone calls while getting the runaround from Humana's mail order service trying to get a patient's Keppra paid for. They were just being started on it for the first time, and Humana wouldn't let the patient fill a short supply at our hospital pharmacy, even though it would take upwards of 3 days for the Keppra to come in the mail so the patient could take it. Delayed the patient's discharge from the hospital that day to ~5pm. I have a ton more terrible mail order pharmacy stories, as I'm sure nearly every pharmacist does, but this one has always stuck out to me as the most infuriating.
So, if the patient had seizures during those three days while unmedicated, well that's just part of Humana's great service, correct?
Dr. G continuing to wage a one man war against United Health care... keep up the fight good sir!
I used to work for United Healthcare. The higher up in management you look, the less they care about people's health. And there is so much political infighting between different teams, that you can hardy call it united. They should change the name to Divided Health Apathy.
You can pry my grocery store pharmacy from my cold, dead hands. Seriously, I love my pharmacists. Sarah and Jorid are amazing and super helpful and when I move out of my current place I'll probably keep going there even if it's super inconvenient.
Also I'm on a Schedule II medication for ADHD which I'm pretty sure I wouldn't be able to do mail-order for, and even if I could I wouldn't bc I'd be afraid of someone stealing it from my mailbox.
Oh, its far worse than that. I take a schedule II; the insurance still makes you do it via mail order, but you can only send the prescription to them when you're almost out, and each month it takes 2 to 3 weeks to process the order for it to arrive. Imagine being without your medications for almost a month.
@@teh_dav2179 yeah no fuck that
The mail order pharmacy will send it, but it has to be signed for by an adult - and that adult must have their ID available. Too bad if they try to deliver while you aren’t there…
@@teh_dav2179 there have been numerous news stories about a shortage of Adderall, so if that's it, that would explain why it has been taken so long. They can't fill what they don't have in stock.
@@teh_dav2179 I am almost in this situation with my new heart meds-- not a controlled substance (if you use too much your heart would just forget what electricity is, so... not really something recreationally viable) but I struggled to find a pharmacy who would actually order it without screwing up the order or freaking out about the physician authorization -- my cardiologist's office was deeply confused by it, as was I, because for once the insurance company got back to us so quickly I actually got _double_ confirmation notices in the mail.
My current grocery store pharmacy, the only one that actually managed to get my medication for me at all, messes up my medication every month; frequently doesn't stock it and has to order it in late/give me a partial refill; has a trainee that works late who will habitually input my information wrong and then snap at me for pointing out that _I do kind of need 60 pills_ for a 30 day supply of a 2x daily medication and can't really afford to pay full price TWICE just because he didn't order the full amount of the medication in AGAIN, and therefore only had five pills to give me, but just charged me for the full 60 pills....which I promptly return then and there so I can actually afford the full amount when it comes in.
I just want the thing that keeps my heart from beating too fast, man. I am at the point of sometimes skipping doses strategically because I know I won't get more until potentially a week after I run out, because if I call early they screw up the order, and if I call later the order's late. I cannot imagine if that took three weeks; I would probably just resort to driving to the hospital and filling all my medications there, maybe, cost be damned? Scary to think about...
I am new to the US and I thought that I was crazy because this was happening to me, and it is crazy, but I have never heard anyone complain about it. So I had started to think that I did something wrong. Maybe I needed to check a certain box, or call a certain number.
It turns out, I was being gaslighted by this crazy system.
Thank you, Dr. Glaucomflecken.
P.S: Am I the only one who constantly gets their voicemail spammed by automatic messages (well, 3/4 of the message, since they start the verbal barrage without waiting for the beep): "...edication is ready. If you want to receive it at home and pay less visit..."
Welcome to the US.
Welcome!!! 💚💚💚
yeah no, everyone in the US gets those automatic message spams dw ! just ignore em
If the message comes from your pharmacy you can ask to not receive those calls when you pick up your next prescription; if it comes from your insurance company you can ask to not receive those calls by calling customer service or asking to stop them if an actual human calls you.
I used to get "helpful reminder calls" from my insurance company if I didn't fill a few key medications a week before the refill date on the bottle, and if I ignored the call for a while and finally answered after my medication was supposed to have run out they would always press me as to why I hadn't filled it yet and if I had enough medicine. Yeah, my doctor appointment didn't quite synch up with my refill schedule so I had a few extra weeks worth. "Oh...Do you want us to call your pharmacy right now and connect you so that you can refill it? It's no charge and we'll connect you directly to the pharmacy team." No, I'm good. Oh, and can I stop getting these calls please? They're pretty annoying. "Sure. At ____ we want our focus to be on you."(or something equally cheesy).
Welcome to the states! Happy to have you here, and I am so, so, deeply sorry for all of the nonsense you have and/or will experience here.
How we have come to allow the same entities to own pharmacies, insurance companies, and drug companies is beyond me.
It’s called lobbying. And payoffs too most likely.
@@Sashazur Oh for sure. We owned a small independent pharmacy for 20 years and I cannot believe the change we saw in that time. It seemed like even if there were lobbyists who were "on our side", they were NEVER on our side.
I think in the same way that we allow people to sell colorful plastic with salt and fat on it.
@@romanandresgonzalezgutierr6406 yeah your comment makes no sense friend
Thanks Republicans
Also, consultation at pharmacies is so important. Don't get me wrong, my doctor does a great job, but most of the medications I use are rotated on a monthly basis, meaning it's sometimes weeks between talking to my doctor and going to pick up the medication. I cannot tell you how invaluable my pharmacists have been in reminding me when and how to use the medications, how to store them, etc. I can't imagine that a mail-order pharmacy would have that same level of caution and helpfulness.
Don't expect much counseling if you go to a CVS or Walgreens either. They've shrunk their employee hours down so much that the staff just plain don't have time to talk to you.
@@falconerd343 I pick up my specialty meds at CVS and the pharmacy tech seems genuinely annoyed that CVS exists lol
@@falconerd343 more like they cannot find enough employees to hire. Pharmacists and Pharmacy Techs are in high demand, at least in some parts of the US.
@@Rosarium2007 its not a staffing problem, its a wage problem. Theyre being paid peanuts but required to have degrees and are far too overbooked. Even when they are not understaffed places like Walgreens will only give them the hours for the bare minimum staff and expect them to do a full staffs worth of work.
In America, medications don't come with instructions inside about the dosage and how to store it?
This video came at the perfect time, when UHC decided not to pay for a refill on a medication I haven't changed or had any issues with since it was prescribed years ago until a week after I was gonna run out. I can't sleep and I'm paranoid, nauseous, and depressed. Thanks for protecting my health, UHC. I love it.
I went with the mail order pharmacy for a couple weeks after starting a new job. I'm chronically ill so the box was always huge, and they also always sent half a dictionary in terms of medication dosage and side effect information. And then one day I opened up the big box they sent and found some extra paperwork--someone else's sheets, on top of mine.
It had this person's full name. The names of their meds, and the dosages, and the disorders they treat. Their home address. Phone number. Medical record number. HIPPA violation backwards, forwards, and through several walls. Closed my account with them that day.
That sounds like the start of some kind of dystopian story.
Oh wait, it's just another day in the US.
Did you contact the other person to let them know what happened?
I moved from a small town to a big city.I miss my old, non-chain pharmacy so much. Virtually never a wait time on the phone, they were always happy to answer questions, they caught it a couple of times when a doctor prescribed something I couldn’t actually take. Man. Those were the days.
As a kid of two pharmacists, please allow me to shake my fist in fury...okay, we're in a different country, but screw mail order pharmacies. Consultation is also important, and has to be always available, damn it.
Here in Sweden we have pharmacy chains where you can choose to physically go to a pharmacy if you need a consultation. If you know what you need you can just log in to their website with your online ID credentials and order what you need, shipped right to your door, or nearest post office.
Which is really convenient for me as a liver transplant recipient 10 years post op. I know what I need and how to take it haha.
Question from Germany: Do different Pharmacies in the US have different prices for the same thing? (Like, say, Ibuprofen from the same manufacturer in the same strength, with the same brand name).
@@RevCode Oh for sure, we don't have pricing regulations for anything. Ibuprofen is over the counter, but pricing on everything is going to be different even between different stores in the same chain
Just checked- CVS has 20 advil brand ibuprofen gelcaps for 80 cents less than Walgreens
@@nicolainielsen7700 My parents actually did deliveries as well, usually for elderly patients, or those who had trouble getting around (especially in the countryside). Either in the evening or after closing, one of them would take the car and drive to the nearby villages around the pharmacy, bring our costumers their medication and such. When I still lived with my parents, I helped too, going to everyone I could reach with my bike and later my first car.
Stay safe doc. Exposing all these frauds is indeed perilous
"Just call our customer service."
"Okay. How is your customer service?"
"Aweful."
No hesitation there🤣🤣
You hit the nail right on the head! Mail order pharmacy is designed to benefit the pharmacy first, the patient second. It works if it's connected to a physical chain, but its just not enough. Can't wait for the investigations to cut these vertical monopolies down!
If I ever get past Dr. Glaucomflecken's (Dr. William Flanary's) super entertaining presentations, I realize that his acting is incredibly thorough and his creativity and humor is top drawer. I've seen all his videos, multiple times, and more. He has helped me get a handle on the health care industry and see it from an inside view. Very revealing.
As a pharmacy tech I can never pass up a good Ole United Healthcare roast, like bruh they don't even fully cover flu shots lmao
I have heard horror stories about UnitedHealth
Isn’t that illegal? AFAIK health plans have to fully cover a predetermined list of immunizations……
That probably depends on the contract with the pharmacy. There is probably another pharmacy where United will pay the whole cost of administration, but the patient may have to call United to find out where.
@@NickCBax they have to cover it Somewhere but it's always somewhere that they own.
United WILL cover a flu shot but you have to be absolutely certain to space every 2 immunizations you need out per year. Which means your flu shot will always be cash payment or full price, even with the highest band of coverage UHC offers. I HATE THEM. Their dental care sucks, their medical insurance sucks, if they offered house, car, or life insurance, I'd sooner grate my face off than use their services ever again.
They are technically the cheapest insurance carrier in the U.S but that cheapness comes at a price. They overcharge you relative to the services you have to gouge them in the eye balls to provide. (Even when it's covered and the clueless Health Insurance Rep. claims that it "isn't covered by your plan".) Ask me how many times I have sat on the phone for hours to get something covered by them.
This exact thing happened to me except they put a block on getting it from my local pharmacy. I had to call and have them undo the block just so I could *order* from my pharmacy... They said they do that for all customers who hadn't ordered through Optum. Thanks for calling these companies on their BS!
If we don't laugh, we will cry from the truth in this. Thank you for taking the comedic approach to this issue.
I mean, surely this has to be against anti-trust laws. There’s no real difference between this and railroads giving unfair rebates to Standard Oil. The Sherman Antitrust Act hasn’t been used in a while but I think it could make a comeback
It could... but the state of influence that the mega wealthy had and the horrific history of the Supreme Court on ANY case involving the mega rich (seriously look it up I think the Supreme Court has sided with wealthy side on financial cases 100% of the time) meaning we would need some real reform before we can curtail their constant consolidation and amassing of all the capital.
underappreciated comment
I work in a specialty pharmacy for a university hospital and we have to tell all the UHC patients they have to fill through Optum Specialty instead of us. Without fail, they always contact the clinic pharmacist a few months later complaining about Optum Specialty and asking what they can do to fill with us.
Yeah, this was me and CVS Caremark too. "Oh your pharmacy coverage put a hold on this, they say you're supposed to do the mail order?" "Ugh, hang on, I'll go yell at them, AGAIN."
I feel this in my soul. I used to be on Medicaid and always got 90 day prescriptions from my local pharmacy no problem. Got on Caremark last year and they cut it to either 30 day prescriptions in store or 90 through mail order. I switched over and sure, I still get the 90 days, but only over a week after I run out of essential everyday medication. Every single time. So helpful... Ugh...
Factual. Pharmacist here. My insurance is basically telling me my pharmacy is out of network and where I should get it filled. You, as a
Patient, have a choice . Please never forget that.
Successful medical practice, versatile acting and writing talent, family man, highly popular RUclips channel, insightful and incisive political commentator....Amazing. May you go from strength to strength!
You forgot TikTok star
@@dennysmith3787 I'm not on Tiktok--I see those vids on YT! 😀
I'm forced to use Accredo by BCBS and this is basically my experience. It's essentially destroyed my health because they're so incompetent. There was a period of literally several months where they could not fill my prescription and they couldn't figure out why, and after that, when that got "resolved," it took over a week for them to get pharmacy approval (??? not prior auth, but something else??) so I could order it. They also always ask me why I don't fill my prescriptions online or using text, but they never send texts and when I try to fill online, it says I have to call. Thanks to all of the delays in getting my meds, I'm actually extremely ill and disabled because my meds stopped working. :) awesome
Cant you apply for medicaid or medicare since your disabled? You wont have to deal with that nonsense anymore if you get approved for it. Im a college student and i work, i was able to apply for medicaid for myself and my child and i have the option to use it their mail order
pharmacy called cvs caremark , but i dont. I prefer to get my meds to an actual regular store pharmacy and medicaid always pays for it.
@@Sadames03 I don't think I'm eligible for Medicaid, I have insurance through my spouse's employer.
We just experienced this with a different insurance company. We went to pick up my husband's meds and instead of the usual $10 no matter what we were picking up, it was $90.
I called the insurance and they said if we want a cheaper price, we must use their mail pharmacy. How much cheaper? $30
"My kid is on Keppra for seizures. I'm not doing that."
"Well, just switch everything else to mail order and pay more for the necessary stuff."
"And what do I do when my local pharmacy closes because you moved all their customers to mail order since my employer is the largest in the region?"
"You'll pay less if you do the mail order."
"Can you even legally mail some of my kid's medications?"
"I don't know but you can try it and find out."
"That would literally risk killing my kid. I know it isn't your fault lady, but you are working for monsters."
Good God this is just horrible
Ugh, once when I was sick as a teen the "preferred" pharmacy was out of my meds. So was the next closest in that chain, and the next and the next and the ne...... The closest pharmacy in that chain was 150 miles away. Or a different pharmacy 2 miles down the road had it. My mother was out of town and my father was trying to reason with the health insurance rep on the phone that leaving his sick kid home alone for over 6 hours wasn't an option. It ended up "only" being about $100 so he ended up just paying out of pocket. Complete and utter bullshit.
Reminds me of an experience I had with CVS. Constantly calling, spamming and emailing begging to go with their mail in system. The CVS store is less than half a mile, the drug is common with a $2 price tag for a 30 day supply. They were honestly trying to woo me with saving 25 cents. I just couldn't believe the effort they were putting forth for so tiny revenue. Gave up on CVS as a result of the experience.
So accurate! I use a specialty med that has to come from a mail order CVS. They cannot - absolutely cannot - ever get it correct, month after month. Not only that, CVS bought out my local independent pharmacy (0.5 miles away) and closed them down. So now I have a 7 mile drive to the next nearest pharmacy.
😅🤣😂 Thanks for the explanation!! Got a letter in the mail about this and was so confused.
Insurance: Use our mail order pharmacy for your Schedule II controlled substance prescription! We'll send you a 90 day supply!
Me: A 90 day supply? For a controlled substance? That my doctor has to prescribe as 3 separate 1-month scripts with no refills? And only the pandemic allowed me to stop needing to physically carry the script with me to the pharmacy?
Insurance: Yes! You can fill that with our mail order pharmacy :)
Doctor: It's literally illegal
MDs in the US (unless there is some state law to the contrary in your state) do have the discretion to write 90-day scripts (some drugs are 84 days) for Schedule II drugs. They might have extra paperwork or such or be limited in the number of patients they can do it for, I'm not sure of the fine print details, but they can do three month supplies. Three months later they have to send a new script to the pharmacy for the next three months. Wash, rinse, repeat.
I get 90 days of adderall through Optum. Also the only place that has it in stock
@@Sb_747 not quite - there are pockets available elsewhere. Problem is finding where. The fact they’ve stockpiled is a real problem though - especially for patients with Caremark/CVS prescription coverage. For some reason CVS really doesn’t have any sense of humor about patients using OptumRx.
@@Rosarium2007Florida has gotten really hinky about controlled substances. And my sister has to take her husband to the doctor EVERY MONTH to get a new prescription for the oxycodone he's been taking for years for a shoulder replacement that has never been pain free.
Might depend on your state. In mine, we can dispense up to 90 days of a C-2, it's just that most insurance will only cover 30, so we do the multiple scripts thing. Also, doctors will only prescribe that much at a time when they're sure it won't be abused
SO TRUE! They will just annoy you into using their mail order. We have a large local company whose insurance plan will only pay for 21 days at a time. Such a pain for everyone involved, patients, pharmacies, and doctors. Ignore the fact that study after study shows that 90 day supplies lead to better health outcomes and better adherence. Nope, getting the profit is most important.
a healthy patient is a patient who pays less on healthcare
ಠ_ಠ
21 days at a time? That's ridiculous.
WOW !!!! Incredible how honest and accurate this is. As an ER doctor I deal with lots of people and see the impact Heath insurance have on the patients. STAY SAFE ALL !
Remember when monopolies used to be illegal?
...me neither, but my grandfather used to say it was pretty nice
Yep, then along came Reagan…
My mom who due to multiple complicated chronic illnesses has a whole drawer full of daily and weekly prescription meds. My family didn't have a car, and my dad walked to the pharmacy a mile and a half away once or twice a month for her meds.
For the first time in a decade the pharmacy messed up. They had just implemented a system where the pharmacy had some meds filled off site and sent to the pharmacy for pick up.
It was a medication that if my mom had blindly took it would have messed up her blood pressure big time.
When my father called the pharmacy the lead pharmacist there listened, and told my dad not to worry (it had just snowed and the sidewalks were not clear yet) he would come with the correct medication around 4pm after he got off work.
He did just that, apologized profusely, looked at the medication my mom got accidentally, and was relieved my mom hadn't taken it.
United Healthcares bullshit system wouldn't have done that for her and my dad.
"Heeeeere's UNITED!!!"
Recently retired pharmacist. Sadly, so true.
These people keep calling my mom every 6 months trying to get her to switch (even though our pharmacy is LITERALLY next door to her place), and it’s a headache every time. WE LIVE IN TEXAS. YOU CANNOT EXPECT INSULIN TO ARRIVE IN THE MAIL ANY TIME BETWEEN MARCH AND OCTOBER AND NOT BE RUINED BY HEAT. Def showing her this next time I go over 🤣
Spend a day or two on the phone with their customer service. Tell every representative that you speak with that you will sue them for harassment of your mother if they don't stop calling. It makes me furious that these companies are so greedy and have to take advantage of our elderly. I had to deal with the insurance for my husband's grandma for a long time, it was a headache all the time. Good luck!
Omg! I love this ! I tried Optum Rx… it’s horrible… and I’m being nice when I say that! It seems like it should be illegal to be charged more for going elsewhere, but it’s an insurance company with well paid lobbyists so they get a pass. If a Dr charged the insurance company more than self paying patients … watch out!!
I had to use a mail order pharmacy while I was on Blue Cross/Blue Shield of Oklahoma. I take a crap ton of meds, so you can imagine how large that bag of 90 days worth of meds was, just hanging out of my little mailbox that is visible from the street. And I live in a neighborhood with lots of elderly people. Nope, not intriguing to a thief at all. 🤦🏻♀️
Especially in the middle of an opioid epidemic. People see medication delivery and hope they’ll get lucky.
The best part is that you actually don't have a choice if you have most employer plans. Usually only 1 fill is covered in the pharmacy and all refills required mail-order. Some plans allow you to *try* and opt out of mail order but it requires you to call and then be put on hold for about 3 hours as they transfer you to about 10 different reps. And then you find out you are using a non-preferred pharmacy so your aspirin that was free is suddenly $15 copay. Brand name drugs? You pay 100% of it +$15 extra out of pocket for the medication but suddenly the copay is $3 if you go into mail order.
No way! Wtf!? That’s horrible!!!!!
100% truth. My insurance doesn’t even give me an option. I have one mail pharmacy choice and if you don’t use it, they don’t cover anything. Not even generics. I have lots of nasty allergies and they are supposed to be following a procedural checklist to keep me safe. I literally had to submit safety violations to my state on every refill last year. It didn’t change anything. So my personal mission this year has been to cause my insurance extra expense. In this case, the insurance and pharmacy are the same company. Every time they send it out without the checklist, I call. They try to reassure me that it was done and I state that if it isn’t in writing in my package, it never happened and my meds aren’t safe to take. They have to resend (at their expense) all my meds. I thought it would only take one time doing this considering my meds cost about $4500/month. They screw it up every month despite assuring me it won’t happen again. It is my personal mission to hit them in the pocketbooks until they either get better or give us another option.
@@jessicawiseman6908 good for you! The only thing that hits them is their pocketbook... You'd think that they would pick on the trend at some point!
As a medical billing a/r specialist (aka I work all the denials these sea monkey brained insurance companies create), optum is the actual bane of my existence. An actual scenario i had a few weeks ago: "Oh, your office got a prior auth from United, but your patients pcp is an optumcare physician? Then the Auth is no good. Yes, Optum owns United. Yes, the patients card says united. But our eligibility portal says that the patients pcp is with optumcare, so you should have gotten an auth with optumcare. You're not the pcp office? Still, your United auth is no good for this patient. You can try to appeal that if you'd like."
This is HILARIOUS 😂 I just told my insurance company to stop stalking me.
They basically impersonated Humana with my 78 year old mother over the phone and made an appt with her for a "house call". The only way she figured out they Weren't Humana was when they gave her a coaster set that said United Healthcare. She was PISSED! She called Humana and they said they've had alot of calls about them and that United was trying to poach customers!
That's absolutely disgusting and has to be illegal!
That's gotta be illegal. Impersonating another company. This could actually be grounds to sue.
This is just not true. If you like one plan over the other, just change your plan.
@@ghiansudelo2590 did you read the op post? She never said she wanted to switch to united health care. She said united health care lied about who they were when phoning her, stating that they were instead another insurance company called humana
That explains the obnoxious calls I got all year. It got bad enough I actually considered trying to call Humana to complain.
Excellent content 😅
It's a nightmare with mail order pharmacies. As a retail pharmacy tech, the amount of arguing we have to deal with from mail orders for transfers is awful.
"We promise we won't give you medication that just looks like yours. It won't be dangerous we promise! Just so you know our promise is not a guarantee."
As someone on ozempic a medication that needs to be refrigerated , I felt this in my soul. $95 for an in store pick up, or $5 delivery with the hopes optum messages me on time with the pick up.
Wtf! I was thinking a difference of $5-10…but $90? That should be illegal!!!!
@@jennifergraceh I'll give you another example I'm also low T in store $40 home delivery...free. it's damn near criminal
Ahhh, yes, mail order. The second thing retail pharmacies hate the most, after prior authorizations.
Nothing like telling a patient who just brought in RXs from the Emergency Room "Sorry, your insurance thinks you can wait a week for that blood thinner for your lung clot."
When I worked for CVS people would get so mad at us for their insurance forcing them to use a mail order, like we could override it so that they could use us.. sigh.
So accurate, I use to know a guy who almost died several times because of these guys. He had a medicine his life literally depended on and they were late delivering it several times once they even sent the wrong meds and refused to send the correct ones because their system said they already sent him his meds. He couldn't get them from a local pharmacy because his copay was way too high. It was bad he ended up quitting his job and getting a new one just to get better health insurance.
My insurance company sent me things for months trying to get me to use their mail order pharmacy and I was finally given an option to tell them to stop sending me ads. I had no idea United Healthcare was doing this to their customers, I'm grateful that the worst I had was a bunch of junk mail and some emails and texts
I recently used a non-coerced localish mail order pharmacy and the service has been great. Wonderful customer service, overnight shipping, cost is 10x less than the local chain pharmacy.
I've never had any chance to get attached to any particular pharmacy, and luckily my experience with mail-order (which goes through the same organization I get my healthcare through, so I'd most likely use their in-house pharmacy anyway if it weren't being mailed to me) has been positive. It pretty much always arrives faster than predicted (it estimates 3-5 days, but I usually have it in 2), I have yet to be sent a wrong prescription, I get a delivery notice, and I don't have to pay for shipping unless I want next-day delivery. It's gone pretty well for me so far.
I always get my first fill at the in-house pharmacy, though. Mail-order still has the info sheet, but no person to explain any of the important points or ask questions. Plus, when I'm prescribed something, I'm generally, y'know... already there in the building, so I can grab it same-day before I go, and just do my refills mail-order.
Internal medicine doc here. Your posts absolutely nail that's rotten about the business of medicine. They make me laugh and p--- me off (not at you) at the same time!
Fun fact doordash delivers pharmaceuticals now as a dasher best pay I've gotten deriving
Good to know!
Can a Doordash driver pick up and deliver my prescriptions, or just over the counter medications?
@@Sashazur the few times I've done it it was prescriptions from the pharmacy of a Kroger and if someone isn't home I just brought it back to the pharmacy
That ending 🤣 Has real The Shining vibes! Bravo Dr G, lol, Bravo!
Sad part is many people need to resort to asking for meds cash.Unfortunately, some medications are cheaper paying cash than going through an insurance and paying a copay... defeating the purpose of even having insurance in the first place.
I had a magnificent piano, lovingly restored inside and out. Had to sell it to pay for daughter's meds. Every year on January 1st we have to start paying completely out of pocket for every thing medical. Yes we keep that in mind when planning christmas, heck i had January's medical bils in mind every fall when we stocked up on sales, because in january we spent the grocery money on medical stuff. But that year was extra hard. I still miss that piano.
I swear to God, trying to get a prescription transfered back out of a mail order pharmacy is just... ugh (am a pharmacist btw)
"Yeah I'm United Healthcare, I need money"
"Sounds like a big load of 'not my problem'"
United Healthcare won't let my wife get her antidepressants filled at our local CVS. It took them 6 months to finally mail us her prescription, while my wife was suffering from Postpartum depression.
The ending where he goes feral demanding money murdered me
The more I watch about United Health the more I feel replused by even seeing their logo
I have United through work for medical, but we don't use their pharmacy coverage, we have a separate pharmacy plan. I had wondered why. Now I know. My employer, amongst other things, owns a mail order pharmacy (and a whole lot of retail pharmacy locations). And for the question on temperature - medications requiring refrigeration are shipped specially packaged to keep them cold and for medications that can be damaged by warm temperatures, during the warm part of the year those are packaged in insulated bags designed to keep the heat out. And the packaging is very nondescript.
Edited to add: I haven't read all 442 comments, but I read a lot of them and the pharmacy my employer owns hasn't been mentioned. Also, if you want job security go train to be a pharmacist or pharmacy tech. There is a shortage in the US. Has been for years. 2020 just made it worse.
We had to go with their mail pharmacy, unfortunately. Going to our local Rx, resulted in being approved only for a 30 day supply each time and higher out of pocket cost. We are older folks and raising a younger child. We didn't have the time or money to keep using our Rx. Frustrating.
Totally agree with the heat issue. It's in a hot mail delivery truck all day and then a hot mail box. I know it has semi crumbled for some people. Not worth it unless you are in a very rural area.
they know that having to deal with mail order pharmacies is the best way to have patients stop taking medications
Let me at least smell it (stiffs through the door crack) this is beyond genius and legendarily hilarious so much so that my family has banned me from watching Dr.Glaucomflecken after a certain time because ill start cackling out loud and wake everyone and the dog up
As a 2nd year pharmacy student, I can confirm this development in retail pharmacy. This branch will be pushed away by online shops in the future sadly. That is also the reason why our teachers begin to train us in working at the hospital and why clinical pharmacy is on the rise. I really hope to become a good pharmacist one day, but what I wish even more is to succeed in a hospital work environment since a bunch of doctors I know who all have high working positions at the hospital are now quitting and saying how horrible it has become since the pandemic
I highly recommend placing in a residency then... Hospital jobs are pretty competitive right now, and usually you need to know somebody and get a good recommendation to get into a decent hospital job. Though at the hospital I work at all our residents get preferred treatment. Meaning, if you do a residency with us, we are going to try and hire you. Though, be prepared because pay will not be as good as in retail. Sometimes 10-20k less than starting at a retail position. Still, personally, CVS/WAG could not pay me enough to deal with the amount of crap retail pharmacists do on the daily.
Get out of pharmacy before it's too late.
I don't think pharmacy will one of the brink and mortar hold outs - same day for antibiotics is so desired.
@@oxnyxws same day shipping is a thing already I’m not so certain that the desire to start medications immediately will prevent it from becoming online dominated.
Because of my medical condition I do appreciate being able to get my medications mailed to me, but I very much value by local pharmacy. I'm going to start start getting my prescriptions delivered from my local pharmacy.
This vignette is spot on correct. Due to their "financial coercion" tactics, I refer to my mail order pharmacy as "the PharMafia."
Also spot on: "Q: How's your customer service? A: Terrible." No matter how wrong they might be-sending the right medication with the wrong dosage, calling my doctor for authorization when there are multiple refills remaining, charging the wrong copay, etc.-they will never, ever admit to being in the wrong or making a mistake.
Correct! Because admitting they made a mistake MIGHT open them up to a lawsuit.
You didn't mention how next month you go to your community pharmacy, but they can't fill your meds because they get a rejected saying it's been filled elsewhere. You swear to them you haven't gone anywhere. Here starts a long investigation of trying to figure out what that other pharmacy is so you can call them and have it reversed only to find out it's a mail order pharmacy that already sent out your meds so they cannot reverse the claim and you're to be getting your meds in 1-7 days 🙃
Can you take them to small claims court over that? Demand compensation for any difference in price, for the delay in getting your meds relative to when you went to buy them, for the emotional damage of worrying that you wouldnt be able to get your meds because they fraudulently claimed your prescription without informing you, for the time you wasted finding out what had happened, for defrauding you by selling you goods without your consent, and for the time you have to waste going to court over it. Should be able to get at least a few hundred dollars without needing to hire a lawyer.
@@SovietReunionYT Especially if it's THEIR mail order pharmacy. Optum rx doesn't deserve to win this one.
@@SovietReunionYT
The thing is, in such a scenario that’s kind of the prescriber’s fault for sending the prescription to the wrong pharmacy first. If we change pharmacy practice so that billing cannot be done before contact with the patient for every fill of every prescription, wait times for prescriptions are going to get a lot longer very quickly… Maybe that’s what we want to do, but at least be aware of the trade-off we’d be making if we choose to go that route.
@@KirisutonoNeko Medical assistant here. Sometimes that happens when a patient asks for a refill but doesn't specify which pharmacy to send the medication to. Sometimes they have 2 or more pharmacies listed. They get mad at us in the office, but if I ask if they specified which pharmacy, the answer is usually no. We're not mind-readers, either. Medication requests done through automated phone or patient portal will default to the first pharmacy listed for the patient.
@@michelleponzio That makes sense. Thanks for sharing that perspective, and sorry for my first line putting all the blame on your side of things.
I actually like the invention of mail order pharmacy. But then I live in a country where there’s no penalty to it. It really is just an option, and in fact my insurance claim doesn’t cover the mail order prescription, and only covers the regular in-person prescription. When it’s applied in a non dysfunctional healthcare system, it’s great for getting simple OTC stuff so you don’t have to get out when you have the flu, and you can get things like travel meds without hitting up pharmacies only to find they’re out and have to go wandering to find one that has what you need. and of course, it only makes sense when medications are by default affordable, so you don’t mind paying for your own for convenience, rather than call upon your insurance cover.
I’ve never been this early to one of his videos. I feel as efficient as Jonathan.
I’ve known our CVS pharmacy for maybe 20 years and I don’t want to ever change.
For a quick second I thought Doc Glauc joined the dark and was doing brand deals for United Healthcare but what we got was way better!
Y'know, for someone who has hated doctors my entire life and has literally only ever had one good experience with a doctor of any sort, I JUMP when I see Dr. G's new video is out.
And yet, some decision makers in New Zealand continually look to the US for examples of *how to improve* our health care system.
I imagine they are looking at how the US is cutting costs while lowering the quality of health care. It's all about money.
@@suemilkbone4868 it's all about rerouting money to insurers. Because the US is one of the most expensive systems in the world, and it doesn't have good, accessible care for all. If it was about using money for good health care, stay the hell away from the US setup.
😢 sorry to hear that.
Customer: Please don't call me again.
UH: Is that a challenge?
CVS Caremark literally won't cover "maintenance" medications (aka any medication that is for a chronic condition) filled anywhere other than CVS. How it's allowed under the anti-kickback statues I'll never understand. Additionally they won't cover pill counts other than 90 day supplies because then CVS can just use the manufacturer's bottle instead of having to dispense it in a traditional orange pill bottle w/ the white cap.
oh man. I am a 4th-year pharmacy student. I will recommend mail-order pharmacy only as a last-ditch effort and only if pillbox packing isn't available where the patient lives. Sometimes, pillpacking is a literal lifesaver for patients with impaired cognition and complicated medication regimens. Many community pharmacies offer this service and I hope more will in the future so we can never recommend mail-order! I really hate how insurance companies are gaining monopolies over healthcare. It feels illegal!
Ha! My pharmacy charges $5 per medication to blister pack those fuckers. $5 per medication. My husband's medication blister packs are $90 a month. And they are making us pay for a robot to pack those blister packs. And we have to double check, and we're blind, that it's even been done correctly.
Because of your video, I did some research and I had no idea how horrible are these for profit companies monopolizing our healthcare system.... We have to stop this madness.
I get my drugs from a federally qualified health center. Pills show up like magic. ❤️❤️❤️
Best editing yet. That transition was flawless.
It's so important to have a good pharmacist. I have had bad doctors, never a bad pharmacist.
I have porch pirates that steal everything I order. After having to replace 3 boxes of meds, they decided to let me go back to the grocery store pharmacy. 😂
Terrifying. Everyday I give gratitude that I am Australian. Thank you Thank you Thank you. You guys need a healthcare revolution.
This could’ve been a great Halloween episode
Big screen adaptation...Why am I envisioning Ryan Reynolds playing both parts?😏
As a former employee of United Healthcare, I can vouch that this is 💯 accurate.
The pharmacy I use is literally a 30 minute drive away from my house because it's the closest human owned store that I could find that offers my medication. Dealing with _any_ chain pharmacy has been a hassle for me in recent years, but since this is a place owned by an actual person that actually gives a damn about my business, they're always absolutely perfect with everything I need
All pharmacies are owned by a person. They aren't suddenly less human just because you get inconvenienced.
the hospitals I've worked for that I get my insurance through have actually made it so that my prescriptions aren't covered UNLESS I use their pharmacies. Either mail order or going in person to one of the hospital pharmacies if I want to go in person. The first hospital told us our ONLY choice was mail order and my medications ended up being 2 months late because they weren't prepared for the influx of customers even tho they were given a year's notice
I was baked af while watching this, and I was concerned about how fast the guy got to your house
I found a way to game the mail order pharmacy and the retail pharmacy into giving me my prescriptions refills early. Living in the sticks, this was useful as winter weather would sometimes mean no meds at the pharmacy and no mail. Always have a 6 month rotating stock of my epilepsy meds on hand
So happy to be a UK resident (although my mother was born in Utah), especially in Wales where prescriptions are free. I'm on almost ten medications and it costs me... Ditto. I'm lucky, I live within yards or 4 pharmacies, including a big independent one. I'm able to order my prescription from my GP surgery via the internet the and can collect it filled at local pharmacy (I choose the independent because they go the extra mile and have more staff than chain pharmacies, thus quicker) in less than 48 hrs... we have a lot of problems from underinvestment the last 12 years but the hellish stuff Dr G highlights isn't any of it thank heavens
oh boy. I get my antidepressants mailed. despite talking to my psych several time and getting the prescription sent in, its has been TWO MONTHS since I last had them. radio silence. two months since ive had my extremely-necessary-for-treating-my-very-severe-depression meds. so fun!