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Living the Praxis for Care 

It Shouldn't Be This Hard!

A few weeks ago, mom was diagnosed with a blood clot in her arm and was prescribed Eliquis to break it up. As we were leaving the emergency room, the doctor gave us a $10 copay card to use at the pharmacy because he said that the medication was extremely expensive. I thanked him and headed home for the evening.

The next morning, I got a text from our pharmacy saying that they didn't have the starter pack for the Eliquis and that they would have to request it and it would take about one to two business days. I called the emergency room back and asked the doctor whether she could wait the two days for it to arrive, to which he said no. So then I had to chase down a pharmacy that actually had the starter pack in stock.

After several phone calls, I found a pharmacy, and the emergency room sent the prescription there, and I just waited to hear when it was ready. Later that day, I got the text that the prescription was ready, so I headed up to the pharmacy to pick it up, and that's when the fun began.

First, mom wasn't eligible to qualify to use the $10 copay card we had been given at the emergency room, and that was fine. I knew she had prescription coverage, but for some reason, the computers at the pharmacy and the computers at Medicare weren't talking to each other, and they weren't picking up her coverage. So I wound up paying $658.79 out of pocket. I was truly salty about that, but I knew she needed the medication, and fortunately, we had the money, so I just paid it.

I got the text from Walmart, which is our normal pharmacy, a couple of days later, and I was really angry because had the doctor allowed us to wait, I would have only paid $4.30 out of pocket. So on Monday, I made phone calls to learn how to get reimbursed if I wasn't having enough fun paying for the medication.

I've had a blast just trying to get reimbursed. It took almost ten business days for Express Scripts to send me the reimbursement form. Then it contained information that well, it requested information that I didn't have, so I had to call back. Then the person told me that she wasn't able to answer my questions about the information that the form wanted because I wasn't listed as her caregiver. So then I had to fill out another online form to become her caregiver, wait a few days, and then call back to make sure that I was filling out the form correctly.

As I was completing the online reimbursement form, it didn't request the information that the paper form did, so that third and fourth phone call wasn't even necessary. Had someone told me, I could have filled this out online trying to get reimbursed for spending money, I shouldn't have had to spend in the first place.

It just shouldn't be this hard.

Well, the forms are done, so now I just have to wait and see how long it's going to take for the reimbursement to be processed.

My encouragement to you this week is to be patient with yourself as you navigate processes and systems that don't have to be as complicated as they often are.

Thank you for reading and bearing with my little rant for the week.

Be well. Until next time, Dr. Sheri.


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Dr. Sheri L. Yarbrough is an author, caregiver, and founder of Praxis Senior Care-Giving Solutions, a consulting business that provides care-givers with practical and easily implemented strategies that can be tailored to meet their individual care needs.

View Dr. Yarbrough's weekly blog on all things caregiving from a caregiver's perspective.

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