Mandatory 90 Day prescriptions


On April 5th, CVS Caremark mailed letters to state of Florida employees on Blue Cross Blue Shield giving them notification that any chronic medications would now be filled ONLY through the CVS Caremark mail order process. This is MANDATORY. It is very likely that state of Florida employees received (by mail) prior warning that their medications must convert to 90-day quantities after the initial three month grace period,  but we think it is likely that people discarded those envelopes unopened.

This creates dilemma on multiple levels.

1.      You may be out of medication.

2.      You could fill a bridge prescription at your local pharmacy but it will be at full cash cost. Your insurance co-pay will NOT apply to the filling of the local, 30-day prescription.

3.      Your physician may not want to give 90 days of a medication. Maybe the dose is being adjusted. Maybe the medication has proven ineffective. Maybe the medication is a controlled substance.

Patients who take medications that are absolutely necessary to maintain their chronic disease states should NOT abruptly stop ANY medications. This includes blood pressure meds, asthma medication, antidepressants, diabetes medications, anti-coagulation drugs like Plavix or Coumadin. Stopping medications can increase your risk for adverse events. Abruptly stopping can also cause severe discontinuation syndromes. If you are uncertain if your medications fall into the ABSOLUTELY NECESSARY categories, please call the office @ 352.377.2022. Leave your message on the voice mail for your physicians medical assistant.

There are chronic medications that could be held temporarily without risk. This will save you the cost of paying CASH to fill a bridge 30-day prescription. You can hold lipid lowering drugs, hormone replacement therapies, osteoporosis treatments, reflux medications, anti-inflammatory drugs used for arthritis, sleep aids and most topical medications.

We at Primary Care Physicians understand that the changes to your insurance benefits are beyond your control. It is purely associated with the state of Florida diligently trying to maintain high quality medical insurance coverage for their employees while managing the ever escalating cost of that insurance. These changes to your prescription drug coverage is the state’s attempt to manage (and maybe lower) cost. We are proud to be Blue Cross Blue Shield providers and are very grateful that the state has continued to provide health insurance through a company with whom we are providers.

It is our mission as your primary care providers to collaborate with you and operate within your insurance coverage as much as possible, to be mindful of your out of pocket expenses and to also be mindful of the overall cost of delivering you the highest quality medical care.  But please be aware…there are recommendations we will make….recommendations that are truly the best standard of care….that your insurance company may NOT consider necessary.

A patient has rights. And a patient has responsibilities. Know your rights. Know your responsibilities. Get online and verify the new benefit structure for your insurance plan. Services once covered may no longer be covered.

April 2011