Q: I’ve been filling my mother’s prescriptions at the same pharmacy without a problem and charged the same co-payment every month. In November when I picked up her prescription, I was charged the full price of the drug. She was not near the doughnut hole. I was told her drug card “was not in the system.” I went ahead and paid the full price because my mother needed the prescription, but what can I do now?
A: Ask for an adjustment and get your money back. To establish the appropriate charge for your mother’s 2011 prescriptions, you will need to ensure that your mother’s 2011 drug card information is correctly entered in the pharmacy’s system. You will also want to have the following documents on hand:
• The receipt for the original purchase with the questioned charge, or if you used a credit card, a copy of the credit card statement.
• A copy of the statement from your mother’s drug plan through October 2011 showing how much was spent year-to-date and how much she had left of her initial coverage limit. This will document that she had not hit the doughnut hole.
Visit the customer service desk and request a refund of the overcharge. If you paid by credit card, make sure you have the card with you for a credit. This may resolve the problem. If it doesn’t, contact your drug plan, tell them the problem, and request forms to file for claim reimbursement.
To learn more about avoiding problems with your drug plan, and how to prevent unnecessary drug costs in 2012, read some of the related Frequently Asked Questions.