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Seniors be aware...
Representatives from this company apparently operate a cut-and -switch operation.
When my wife and I decided to select a different Part D provider, I called into [protected] and spoke with their representative. During the discussion I advised that I was looking for a new Part D provider and would like to check all the medications both my wife and I were on.
I was advised that all the named medications were on their formulary although some of the medications were generic and some Brand names. They indicated that the co-pays would vary depending on the medication. That seemed reasonable enough to me so I went to the WWW.MEDICARE.GOV site and had one of the Medicare Representatives enroll both of us in the First Health Part D Plan...and simultaneously dis-enroll me from the other plan we had used for 2009.
Then after Jan 1st, 2010 I went into the same pharmacy we had used the previous year and registered the new coverage...At that time I gave them some prescriptions for my wife and one included LASIX which was one I had specifically advised by the First Health Part D representative was covered...Upon picking up the medication for a 30 day period, I was then advised that that medication was not covered and that we would have to get with the Physician and get him to change the prescription to FUROSEMIDE...Within a few days we received notification in writing and I called the First Health Part D and was advised by a First Health Part D representative that First Health Part D would not continue to pay for that unless the Physician had used alternate medications within a 120 day period immediately prior to our enrollment.
That really infuriated me and then I informed the representative that I had previously had one of their representatives advise me the drug was covered and in their formulary before we enrolled in the plan...Well I let them know in no uncertain terms that I wasn't happy with that response and that I had been lied to by a representative of First Health Part D. I even reminded the Representative that when I discussed all the medications my wife and I took were told at the very front end of the conversation that the conversation was being recorded. I gave both my wife and my names and Medicare number and effective date...Well I requested that First Health Part D go back and play that recording and it would be clear that I had discussed it and that the First Health Part D representative advised me at that time all were covered...I was then advised that unless I could pin the call down to a specific day and hour, they couldn't do that as they had millions of phone calls to sort through...I then asked for and got assistance from them in registering a formal complaint however that was as bogus as a $3.00 US Bill. ...Shortly afterwards First Health Part D sent an inquiry to the Physician and I understand that they asked him to provide the names of all medications similar to Lasix he had prescribed to my wife and requested he provide them wihh all her medical records relative to the duretic...Well my Physician advised me that he told them that it would cost him at least $25.00 and that if they would forward that amount he would...
It is very clear that First Health Part D uses an intimidation policy especially when someone complains and that they can beat the complaint as most Physicians are not going to go to that trouble...Whats wrong with a Licensed Physician simply telling them on the phone or faxing a short explanation? No copies of Medical Records should be necessary to solve a simple question substitution...
With First Health Part D the cost of Lasix vs Furosemide is less than the money the Physician would have to expend to satisfy First Health Part D...
During that same first discussion prior to joining the plan, I gave another drug called DIOVAN. I was advised that it too was covered in the Formulary...Several weeks after enrolling in First Health Part D and specifically yesterday, we received a written notice from First Health Part D that they WOULD NOT COVER that medication until the Physician had tried AVAPRO or MICARDIS...Our Physician has had to try various medications in the past couple years and at one time she was on 3 different Blood Pressure Medications as he tried to get her BP down below 280...Now First Health Part D wants to experiment and try other drugs, too hell with what that will possibly do with her Blood Pressure...God only knows how many pages of her Medical History the Physician would be asked to furnish them to quench their intimidating attitude...
Well my cup runneth over with this First Health Part D and as far as I'm concerned their plan is a "POS"! My wife and I would switch away from this "POS" today if it were possible but unfortunately the Medicare rules that substantially favor the Insurance Company won't allow a switch until next year so we are two seniors on a fixed income that has been lied too and taken advantage of by First Health Part D and are now paying the price while the insurance company fattens their coffures...so I would stringly advise any of you older people who are considering enrolling with this carrier, seriously reconsider. Caveat Emptor!
J. Leon Pringle, Jr
The complaint has been investigated and resolved to the customer’s satisfaction.
Do you know what the side effects are with Lasix?
Do you know that NO - (let me repeat NO Significant amount of) seniors were in the research and studies for this drug?
I had to drop First health because of their mindless problems, inconsistencies and intrusions into my health plan. They are quick to point out that they must follow Medicare approved policies as they change their formularies, and deductibles, raise premiums and otherwise get between you and your physician.
Warning!. There is not a dime's worth of difference between them and their brethren. I switched to Costco/Aetna and ran into the doughnut hole in just over two months because of the rising costs, rising co-pays, rising deductibles and the company's right to charge whatever they want for the retail price.
My wife went into the doughnut hole with AARP's plan because her last prescription cost her $1750 for two weeks. This price exceeds the cost of GOLD!
The Government, AARP and others set up this money-making plan where they are all too easily enriched at the expense of consumers. Customer service has become a slick joke. From the Dr's office I took my wife to the CVS drugstore for 21 pills to stop her vomiting. The insurance company said no. CVS took a week to write to the Dr. I called Aetna in an hour only to be told that I can file an appeal to some review committee and get a responst in a few weeks. My wife kept vomiting from a serious viral issue. The AARP insurance company said no to her, the CVS druggist was helpless, our premiums continued, no drugs were forthcoming, and my wife kept vomiting.
Everyone was making money but no service was offered. They all insist that they follow Medicare rules which cover their collective ###. My wife kept vomiting. We keep paying premiums. We would be penalized if we quit. Congress and Bush contrived this plan and Obama cannot fix it!
This is a sample of what's to come. This cannot be the world's greatest health system!
The donut hole will close in a decade after millions of seniors will have died from age, illness, lack of meds and government sponsored health plans. Insurers will set their own retail prices, continue to raise premiums, copays and deductibles. You can't win; you can't quit; you can't even break even. This is the new American business model.
First Health was no better than the others three plans we have tried. It is the plans and insurers that stink. The contrived prices, nonstop premiums, stopped service, poor service, unreliable formularies, and excess profiteering killed this concept by design.
I just went in to pick up a prescription on Saturday to discover that I now have a deductible even though I had paid for a plan with no deductible. The deductible is not huge, but it is the principle. When I contacted First Health partD to see what was going on, I was told they reserved the right to change the terms of the policy at their discretion. I contacted Medicare and they confirmed that. Now I have a policy which not only has a deductible but doesn't cover many of my meds either. This company is using bait and switch tactics, beware.