DH's New Part D from SilverScript is a Disaster

chisueJanuary 3, 2013

I'm glad we've both had the shingles vaccine or I would probably be erupting in a rash by now.

This company is so mixed up. It is unbelievable.

Dec. 10 DH took two prescriptions into CVS. He also gave them the membership codes he'd received from his new Part D insurance plan with Silverscript. He said he would be needing the prescriptions January 2 or 3 because we depart for Maui for two months on Jan. 4 and because he has meds only through Jan. 3. CVS said to call Jan. 1 to have the prescriptions filled -- which he did.

Silverscript tells the pharmacy they can't find DH as a member. They will not authorize co-payment. We and the pharmacist have spent *hours* on hold trying to get through to Silverscript or to a 'supervisor'. DH tried at midnight last night -- was on hold for half an hour without a response before he gave up.

I called this morning at 7:30. After 20 minutes on hold, I'm told they are updating their system. They can confirm his membership... within 72 hours! "We are always very busy at this time of year." (Can't PLAN AHEAD for this?)

Gah! We'll be out of town in less than 24 hours. We are invited to pay for the meds out of pocket and MAIL Silverscript the receipts to APPLY for reimbursement. The two meds total $1286 for a two-month supply.

We waited until the new year because these meds are so expensive. DH was in the 'gap' June - December of 2012. This is not the first year we've gotten meds from a new insurance company plan the first of the year.

Why do I have no confidence that we will be reimbursed? Could it be the sloppy performance so far?

Thanks for being my 'stress relievers'.

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Was this the cheapest provider when you changed Part D coverage?

    Bookmark   January 3, 2013 at 11:47AM
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Wow. I thank you for posting this. Every month I am annoyed that I have to cough up $37 to UnitedHealthcare for prescription coverage. I take two simple meds that wouldn't cost $37 a month if I paid for them out of pocket. I am so tempted to drop the RX coverage. However, reading your post reminds me why I need this, the same way I need auto insurance. I've also been tempted to switch to a HMO type coverage for less money.

However, UH does a good job of covering me and being accurate and professional. Those things have value, too. I guess your DH can't switch until the next open enrollment. Why did you choose this company? Just curious. I hope they get their act together soon.

I wish I were going to Maui.

    Bookmark   January 3, 2013 at 11:48AM
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If it is too bad, is there some way the state can step in to help out? Or Medicare? I sure would call Medicare or Social Security, when you get back.

    Bookmark   January 3, 2013 at 12:06PM
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Well we have Silver script and haven't had a single issue...Ours started the first of the year and we have had several prescriptions filled already.

If you have your prescriptions at one of the major drug places like Wal-Mart or CVS, Walgreens, you shouldn't have trouble having them filled from anywhere you are on the road or traveling...

I haven't tried to fill anything from Maui but I'd be willing to bet it can be done easily...

    Bookmark   January 3, 2013 at 1:16PM
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Ruthie -- Encouraging to hear someone who has had no problems with Silverscript. Are you new to them or did you have them last year? My Part D for 2013 is the same United HealthCare Plan we BOTH had for 2012. DH switched because the savings was considerable, and he has $$$ meds. He'll still be in the 'gap' by July, but the annual coast for meds + plan is a few hundred less than continuing with United HealthCare -- IF Silverscript can ever get to *recognize* him.

His plan payment is coming out of his SS. Silverscript has his SS number, but they continue to confuse him with another man who has the same first and last names (different middle initial) and who has the same DOB -- but, of course (I sure HOPE!) has a different SS number.

We'd been using CVS in our town anyway and thought this would be 'all in the same family'. NOT! United HealthCare has required me to switch back to Walgreens.

Both chains are on Maui. We are going to have to get his meds sorted out once we're out there. The local CVS has given DH ten of one of his meds. We'll be OK for a few days. (You can fill any non-narcotic med in Hawaii. Be aware that pain meds require a prescription from an MD licensed to practice in Hawaii.)

Sushipup -- This was LESS than his prior plan, but not the rock bottom cheapest. That was something I'd never heard of. Thought we were 'safe' with the CareMark product.

Dedtired -- When you start on Medicare you MUST have a Part D plan or pay a penalty when you want it later. DH has to pay a penalty. He never *needed* drug coverage until two years ago. Then, boom, some really expensive meds.

Marie -- We can pay the bill. It's just so aggravating, epecially when we are trying to 'get out of town'.

    Bookmark   January 3, 2013 at 3:54PM
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Read this:


If you google search "silverscript problems" you will also find a link to the medicare.gov site which gives actual text of the letter sent from CMS to SilverScript telling them to cease marketing until IT problems are fixed. It sounds like one BIG mess.

Here is a link that might be useful: silverscript

    Bookmark   March 4, 2013 at 10:53PM
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ravencajun Zone 8b TX

oh wow what a mess they have created, sounds like you need to call the number given in the article, how sad that so many people are without their meds.

    Bookmark   March 5, 2013 at 2:44AM
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lethean -- Thanks for posting that link to the story. The screw-ups continued while we were on Maui.

DH has now received a second set of membership cards and a 'welcoming' letter from SilverScript. (Identical to what he already had back when they 'couldn't find him as a member' in early January.) Our experience was exactly as frustrating as that of the person quoted in the Sun-Sentinal article.

We continued to have some 'recognition' problems on Maui. There was also a discrepancy between what SilverScript quoted as the retail price for DH's meds and the retail the pharmacy on Maui actually charged -- about DOUBLE charged over what was quoted. (He only needed six pills so I was waiting until we got home to see if this continues before reporting this to Medicare.) I was unhappy to have to call the pharmacy to ask the retail price too. It was not printed ON the prescription label.

I wish I could get retail price quotes from SilverScript IN WRITING to have some 'proof'. I have the pharmacy bill.

    Bookmark   March 5, 2013 at 11:41AM
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I started SilverScript Jan 1, 2015 and it has been a mess. The person who is happy with SS must work for them or never has to use SS for much.

I hear same rep voices now as when called for plan info last year. One rep arrogantly said this year he does it all so have to go thru him when he was giving wrong info on how to do mail order which botched things up.

If rep sounds same & wrong info, hang up & call back for someone else.

They cancelled a med I can't be without b/c dr sent fax as instructed by them, but a pharm tech sent a request bak for something else, dr sent within 3 working days, & after on hold 30 mins rep snottily said it was 5 days since dr. given notice late fri afternoon (said weekend counted as days; really? what doc works weekends besides er?). They had cancelled my med w/o notice & I they have email & phone options on. So had to start over again! (oh, I could pay extra $ for rush bc was on cusp of having no med I can't do without more than a day...almost 2 weeks to get med via dr fax).

Last night from er, another rude rep gave wrong info (common problem it seems) on med 1 & said they couldn't give price for med 2 they covered. I was patient, calm, walking them thru step by step bc obvious they lack training.

Guessing SS has low paid, low number of reps (for my area?), w/ little training, and is why I so often get lousy attitudes & help.

I tried to file a complaint on medicare's site, but it wouldn't take my submission b/c too many characters when my editor showed I was well under their limit.

I called Medicare & guy said he was surprised I was complaining about SS because they are good (not a good sign & told him I expected better from caremark cvs related company.). I also said last year's med d company was not like this...but maybe I get what I pay for w SS.

He put me on hold for a tech person to help,checked back periodically, then I got disconnected after 25 minutes on hold. Arg! I gave up. Maybe this is how they keep ratings decent. I don't know tho.

Yes, they have cheap premiums that offset their higher med costs. I will switch Med D co. next year; not worth $ it.

    Bookmark   March 9, 2015 at 3:46PM
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Chisue, what a mess. I have no insight for you as our drug and health insurance plans in Canada are so different. (((((hugs)))))) are all I can offer.

    Bookmark   March 9, 2015 at 3:59PM
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ravencajun Zone 8b TX

just a heads up this is a very old thread.

    Bookmark   March 9, 2015 at 5:02PM
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