Are all pharmacies created equal?

I've been put on some new medication and it seems my insurance keeps asking for preauthorization (or co-morbidities) and then they reject it so I either have to pay cash or switch to something else. It's getting annoying and I can never get a straight answer from my (usually) "good" insurance provider.

But mainly I want to know if you have better "luck" at other pharmacies, prices, etc? My DR gave me a manufacturer's $0 copay card and CVS couldn't figure out how to process it.

I don't mind switching pharmacies for better service, knowledge, etc.

Re: Are all pharmacies created equal?

I can't really answer for better service or knowledge.

But for my Insurance company, I log into their website; and it allows you to "find drug costs". You enter in the name and it gives you all the pharmacies costs including a mail order; to see who is cheapest.

Ironically, I have found some in the past; to be the cheapest if you fill them at Costco. You don't have to be a member either. You can call them to see if they carry it and how much they would charge you.

Message edited 10/4/2018 12:08:08 PM.

Are all pharmacies created equal?

the small pharmacies are much easier to work with. They will help you with discounts and talk to your insurance. Not sure where you are but we have 2 great ones in Huntington

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Appeal with your insurance company to cover the drug. PITA, but worth a shot.
Keep pestering your insurance company and escalate to a supervisor / manager to get answers.

Try a local pharmacy rather than a chain. That might help with using the card your doctor gave you.

Lastly, I'd contact the drug manufacturer to get answers - find out why pre-authorization is needed and if they offer lower any financial aid.

Are all pharmacies created equal?

Try the app Good Rx, you can put in your med and they will tell you the local prices to get it around you.

Are all pharmacies created equal?

CVS is always a problem and the pediatrician even said she has heard nothing but horror stories about many locations.

Are all pharmacies created equal?

If the insurance is denying it, it will be denied everywhere. Just like your copay will be the same no matter where you go.

In terms of the copay card, will it cover the entire cost or only a copay? If it’s just a copay, it wouldn’t apply in your case because you are responsible for the full amount.

I’m not a fan of chain pharmacies, either, but I can’t find an independent one in my neighborhood. I worked in an independent pharmacy when I was younger and in instances such as yours they would call the doctor and explain that the drug wasn’t covered and ask if they would be willing to prescribe an equivalent. Regardless, I don’t think it matters here because a different pharmacy can’t make the insurance pay.

Are all pharmacies created equal?

When I was a kid my parents only used chains. It was just easier. When DH and I moved I started using the small family owned pharmacy his parents used. You couldn't pay me to switch back. They ask how my DS is, my MIL, all by name. Its really nice. Beyond that, they have the best customer service. I was recently put on a new anti-inflammatory and it wasn't a DAW script. The pharmacist told me that he only ever charges and bills for generic but he thinks the product is garbage and will only order and dispense the name brand drug. There's no way a chain pharmacy would ever do that. They're the best!

ETA: I now live 25 minutes from this pharmacy and still go there. Its just not worth it to me to switch.

Message edited 10/4/2018 1:24:44 PM.

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I had the opposite problem. Always grew up going to a small local pharmacy, went there as an adult and literally everytime I went to get a medication, there was always some issue with insurance. I think they were coding things incorrectly? I'm not sure but I started going to CVS about three years ago and mysteriously, all of my insurance problems ceased to exist. LOL.

Re: Are all pharmacies created equal?

My problem is all the mom and pop type pharmacies in my area are long gone now.

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We use CVS. A few weeks ago DS's rx was not approved but the dr's office just had to call the insurance company and then it went through. You have to stay on top of everyone.

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Are all pharmacies created equal?

I dislike all CVS but for the one in Hicksville Jerusalem ave. I switched to a small Pharm again 2 months ago. They know, I dont wait on long lines with my personal info being asked.
NOT all are created the same, each one charges a different fee depending on their vendors too

my pharmacy will deliver the meds to my home or work

I also grew up going to small privately owned pharmacy, they still know me today. I remember them from when I was a kid.

Message edited 10/4/2018 9:16:19 PM.

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Re: Are all pharmacies created equal?

I had nothing but problems with CVS and getting something for my son. Kept getting denied by the insurance, kept not having it in stock, tons of phone calls back and forth for months. It was awful.
Finally, I switched to a pharmacy that was recommended to me. They are located in Bayside but they deliver to LI and you have your perscription 24 hours later. All of a sudden insurance wasn't denying the same exact prescription. Haven't had a single issue since. I'm never going back!

Message edited 10/4/2018 10:10:42 PM.

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Message edited 3/29/2020 4:42:37 PM.

Re: Are all pharmacies created equal?

CVS is the worst! I will never go there. They even admitted to me once they are the highest.
I was getting eye drops for my son. The cost was pricey so I called the ped and they said they'd give me another prescription for one like it, but cheaper. My friend told me to ask for it bc she had the same thing with her daughter and she paid like $11. At CVS they rang it up to like $40. I said a friend told me she got it cheaper from Walmart. The CVS guy said... yes, they are always cheaper.
I'm like... thanks, bye!

I went to Walmart and have been going back there since. Never CVS again.

Are all pharmacies created equal?

Thanks everyone! A lot of you echo what I'd already thought - CVS definitely is more expensive pricewise, and the staff does seem to be part of the issue if they aren't experienced/know how to handle the insurance aspect.

I have used GoodRX to find the cash price of certain meds, but it seems like all of a sudden my insurance doesn't want to cover fairly reasonable medications (nothing wildly out of the ordinary and all obviously prescribed by physicians/specialists). I am going to look into a smaller pharmacy, I just need one with decent hours since I tend to be all over the place.

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Are all pharmacies created equal?

The issue we had with CVS wound up being on our insurance company's end. They forgot to click something to make my son eligible for prescription meds. And he was like two (and got sick often because he was building up his immune system), so you can imagine how infuriating it was for CVS to tell us he wasn't covered every time we went there, DH to call the insurance company, and them to tell us everything looked fine. It was a YEAR before they were like, "Oops, forgot to check off this box in our computer system, sorry about that."

We ultimately ended up switching from CVS to a local drug store because DS is on meds for ADHD and we had to wait a week for them. The local drug store always has them in stock.