Blue Shield of California offers health plans through Covered Ca.Com. So I bought the Ultimate PPO which has everything for my needs. I have been a member since Feb 1, 2014 and have paid the monthly dues always on time. I contacted Blue Shield to start my prescription. They sent me to a group plan department. After talking to a couple of representatives they said I should talk to the individual plan department. They send you through these departments to see if you are eligible.
Of course, I am eligible. They want to take info about my prescription needs and see if they can afford it.
After talking to a couple of representatives in the individual plan department they sent me to PrimeMail. After talking to lots of representatives in the PrimeMail department I finally reached their pharmacist who says that they will send me my prescription once it is approved. PrimeMail is a specialty pharmacy. By this time more than two weeks has gone by and my meds are beginning to run out and I was glad to hear that they are a specialty pharmacy who has the meds I need. But, No notice was sent to me about my prescription for several days. So I called PrimeMail and they say that Blue Shield says that Caremark will take care of me. I have never heard of Primemail until they sent me their member booklet. I have never heard of Caremark until Blue Shield sent me a notice about Caremark.
PrimeMail should honor my prescription instead of Caremark. They simply dont want to. They arent fair and honest.
I have called Caremark for more than a week and each time they say that they need to "verify" my prescription. I ask them how long will it take? They never answer. So I call Blue Shield to complain and they say you must wait. They also say we will approve of your prescription. They never answer when. Both will say it takes time to verify and approve but never when. I tell them several times that I am running out of prescription meds so please Hurry!!! I need to take this prescription everyday and cannot miss a day. After so much run around they gave me and its almost a month and I'm really almost out of meds and after reading the Rip Off reports I dont think they will approve of my prescription. So I decide to call CoveredCa.Com and they say I can change providers. Thanks.
I also checked Rip Off Report and find there are hundreds and hundreds of complaints against Blue Shield, PrimeMail, and Caremark. People must take their meds. After reading about the hundreds and hundred of complaints I find these companies to be RIp Offs. They will take your money. They are not there to help people. You wil be very dissapointed. Dont get the run around. Dont get ripped off. Please dont waste your time or your money with these companies.
David
Milpitas,#2Author of original report
Wed, April 16, 2014
Finally, Caremark called to notify me that my prescription is approved and I can order. It is more expensive than my previous pharmacy but something is better than nothing. You will never know what pharmacy you may encounter. You wont know what they will charge until you find out. I hope that all insurance companies and all pharmacies will always be fair and affordable in every way including specialty pharmacy for all. Keep shopping around and compare.