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Pharmacy MTM fee
Posted on 5/16/24 at 5:25 pm
Posted on 5/16/24 at 5:25 pm
I just picked up my kids medicine, and was hit with a 50% extra charge for "MTS". The pharmacy told me it was because my insurance was not paying them enough.
They are the only ones local that carry this medication, so I had no choice. I googled MTM fee, and it looks like it should be for medication therapy management that we clearly dont need and they did not provide. Will research more, but I am sure it is legal in some way. Very pissed. Anyone know about this?
They are the only ones local that carry this medication, so I had no choice. I googled MTM fee, and it looks like it should be for medication therapy management that we clearly dont need and they did not provide. Will research more, but I am sure it is legal in some way. Very pissed. Anyone know about this?
7
Posted on 5/16/24 at 5:28 pm to bushwacker
Guess you’ll have to give up the cigarettes and beer.
Which pharmacy?
Which pharmacy?
Posted on 5/16/24 at 5:30 pm to bushwacker
Just get off your HIV meds. Problem solved
Posted on 5/16/24 at 5:33 pm to bushwacker
It’s not legal for a lot of reasons. They can’t charge your insurance and you at the same time, and if they can’t prove they actually provided MTM services, they will get bounced.
Submit a complaint to the board of pharmacy and your insurance company.
Submit a complaint to the board of pharmacy and your insurance company.
Posted on 5/16/24 at 5:48 pm to Tempratt
Farmers Drugs in youngsville. I emailed the info to the pharmacy board.
Nope no more aids drugs for me! good one. that's my go to anytime my wife complains of something wrong..........always the aids.
Nope no more aids drugs for me! good one. that's my go to anytime my wife complains of something wrong..........always the aids.
Posted on 5/16/24 at 6:28 pm to bushwacker
Pharmacy guy here. Either a pharmacy accepts the reimbursement from an insurance, or charge you off insurance. We cannot charge both. It is legal for us not to accept an insurance reimbursement. Many many times a drug reimbursement does not cover the cost of the drug.
Posted on 5/17/24 at 9:22 pm to tigerbait3488
And that’s why your name brand drugs are “out of stock.” Your insurance company that makes billions of dollars per year pays your pharmacy less than the pharmacy pays for the drug so we quit stocking it. And by the way your insurance company makes the drug manufacturers give them a rebate of about 70% on brand names. So if you wonder who is making your drug prices so high look on the stock exchange to see where express scripts, Caremark and the like land. Your politicians are on the take from the insurance companies so they protect the rebate/kick back. Now you know the real story.
Posted on 5/18/24 at 5:36 pm to rph1
Bingo
Posted on 5/18/24 at 5:43 pm to rph1
quote:
So if you wonder who is making your drug prices so high look on the stock exchange to see where express scripts, Caremark and the like land. Your politicians are on the take from the insurance companies so they protect the rebate/kick back. Now you know the real story.
Prescription drugs are high because drug companies front load all of their profits and R&D costs while they still have exclusivity.
Go look at prices for the same exact drug in other countries. It’s significantly less. The drug companies set their own prices in the US where they don’t in Europe.
Posted on 5/18/24 at 6:40 pm to bushwacker
Did they ask for a tip too?
Posted on 5/18/24 at 7:52 pm to tigerbait3488
quote:this is so stupid what the insurance company has done to pharmacies. Now you are stuck with hell holes as all the mom and pops are closing.
Many many times a drug reimbursement does not cover the cost of the drug.
I used to pay like 12 bucks a month for a generic med I have taken for a decade. It is now a little over a buck. I wasn’t bitching before. But now my local little pharmacy got bought by fricking CVS.
Posted on 5/18/24 at 7:57 pm to tigerfoot
Independents are struggling to stay afloat without any other services such as Compounding and DME. Also, we service almost all the hospices and facilities in the area.
Posted on 5/18/24 at 8:07 pm to bushwacker
It’s criminal what the insurance companies are doing. The pharmacy can only accept so many $20 to $100 loses per prescription. They may make $5 on average on other prescriptions. That’s not a sustainable business model and unless there are drastic changes to reimbursement, there will be a huge disruption of pharmacy services in the coming years.
That’s not even accounting for these post-paid audits where an insurance company may recoup the total amount that they paid due to a provider not writing the amount of grams daily of a cream to use on a rash. It’s insane.
That’s not even accounting for these post-paid audits where an insurance company may recoup the total amount that they paid due to a provider not writing the amount of grams daily of a cream to use on a rash. It’s insane.
Posted on 5/23/24 at 10:04 am to bushwacker
No other business model in America sells at a loss, especially medications. If your insurance can’t make him whole then go somewhere else. Do you expect him to lose money on your prescription? There’s a reason no one else has it in stock, it’s because they lose money! Be thankful he’s willing to stock it and continuing to support you and your family. Go stand in line at CVS, Walmart, or Walgreens and report back on the shitty service you will receive. Farmers Drugs provides great service and will go above and beyond to meet your needs….
Posted on 5/23/24 at 10:36 am to rphtiger
quote:
Farmers Drugs provides great service and will go above and beyond to meet your needs….
quote:
rphtiger
Posted on 5/23/24 at 11:21 am to tigerfoot
quote:
this is so stupid what the insurance company has done to pharmacies. Now you are stuck with hell holes as all the mom and pops are closing. I used to pay like 12 bucks a month for a generic med I have taken for a decade. It is now a little over a buck. I wasn’t bitching before. But now my local little pharmacy got bought by fricking CVS.
I'd suggest you all write to your representatives.
Things will only get worse. If nothing changes in the near future your choices will be CVS and Walgreens and your prescription wait time will be 5 hours
Posted on 5/23/24 at 11:25 am to rph1
quote:
And that’s why your name brand drugs are “out of stock.” Your insurance company that makes billions of dollars per year pays your pharmacy less than the pharmacy pays for the drug so we quit stocking it. And by the way your insurance company makes the drug manufacturers give them a rebate of about 70% on brand names. So if you wonder who is making your drug prices so high look on the stock exchange to see where express scripts, Caremark and the like land. Your politicians are on the take from the insurance companies so they protect the rebate/kick back. Now you know the real story.
Posted on 5/23/24 at 11:32 am to Walt OReilly
quote:
Did they ask for a tip too?
Sounds like they gave him the tip then went in dry.
Posted on 5/23/24 at 11:33 am to bushwacker
You called the board of pharmacy? What a douche. That would be the last time I filled any of your prescriptions. I hope Farmer’s sends you to Walgreens so you can wait in line for 3 hours and then be told that they don’t have the medicine.
Posted on 5/23/24 at 11:45 am to rph1
Total douche move by the OP. But people really are ignorant about what is going on. Their first inclination is to say " they trying to rob us, I'm callin sumbody!! I'm taking my script somewheres else!!." Only to show back up at your store the following week wanting you to fill it again.
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