CVS Archives - Page 2 of 3 - Ramblin' with Roger

Insurance stress: CDPHP, St. Peter’s

health insurance

I am experiencing some insurance stress based on two pieces of mail my wife and daughter received the same day last week. If you want to write a blues song after reading this, feel free.

The letter was from St. Peter’s Health Partners. It runs most of the city’s hospitals, clinics, and doctors’ offices that aren’t part of the Albany Medical Center. All of our primary care physicians are part of SPHP.

“Our records show that at the time of your last visit…, you… receive your health through a CDPHP commercial health plan.” CDPHP is the Capital District Community Health Plan. “Please be aware that [SPHP] has engaged in negotiations with CDPHP for a more equitable agreement to ensure we can continue to deliver high-quality, community-based care.”

Didn’t we do this dance a few years ago, which got resolved at the 11th hour?

In bold: “Our current agreement is set to expire effective January 1, 2023; meaning some patients may have increased financial responsibility when seeking care from [SPHP] in 2023 because CDPHP no longer includes the following facilities in its network.” Over a dozen facilities, including St. Peter’s Hospital, Samaritan Hospital, and five Eddy facilities, are on the list. Interestingly, no related mail from CDPHP has arrived.

On the coverage

Meanwhile, my wife and my daughter also received a Benefits Bulletin from my former employer, the Research Foundation for The State University of New York, or SUNY RF. “If you are a retiree or an eligible dependent of a retiree and you are not eligible for Medicare, your current RF benefits will continue for 2023 unless you make changes during open enrollment.” That window is November 1-30.

Just in case we need to make a change, I went to the SUNY RF portal to see if I could find the forms to change their coverage, but none of them seemed appropriate. Some were for the retiree (me), while some were for the retiree and dependents. I am on a different plan for administrative reasons.

So I called the SUNY RF number on Monday and then a different one on Wednesday. I was offered the same form to make changes, even though it didn’t make sense to me. If I change my wife and daughter to a Blue Cross program, I hope SUNY RF does not muck it up.

CVS

Meanwhile, a good friend of mine writes on Facebook: “We’ve…just been notified by [CDPHP] that CVS will no longer take our prescription insurance effective 1/1/2023… This is very upsetting because CVS is very convenient to where we live, has a drive-through, and the closest to our house is one of the only 24-hour pharmacies in the Capital District.” We got no such letter from CDPHP.

I called my local CVS pharmacist. They said that CVS has declined to take the CDPHP price schedule, so it may very well cost more to fill prescriptions there, but they won’t really know until they start filling them next year.

This issue will be a primary concern of mine this month because I can’t wait until the CDPHP/SPHP issue gets resolved in December if, in fact, it does.

Time on the telephone

People occasionally ask me what I do with my time, now that I’m retired. The more correct question is how did I get through the week when I was working?

I spend a lot of time on the telephone because I’m “free”. So if my daughter is getting a vaccine for school, but we don’t remember the time of the appointment, I call her doctor. The initial message says there are 24 people in the queue. It also says I’ll get to speak to a human being in “three minutes, and fifty-four minutes.” So the countdown begins every 30 seconds: 22 minutes in the line, 21, 19, 17, et al. Do I want to press 1 and have them call back? I did that with Amtrak, but I knew the wait would be over an hour. I stayed for 16 minutes, as it turned out.

The cable box from Spectrum is not working properly. Before I call, I always reboot the system. Then the auto-voice character does the same thing. When I call back, I eventually get a human. I’m told that I have a “known problem.” So I can set shows to record, they do record, but they don’t show on the menu is a “known problem”? The only solution is to switch out the box.

Overpriced Rx

I received an amazingly mangled folded-over postcard. It was regarding a “$345 million dollar epinephrine (Epipen) class action settlement with Pzifer.” To file a “consumer claim,” I did not “need to provide any documentation at this time. However, the Settlement Administrator may ask for additional proof supporting your claim.” BTW, the lawsuit is regarding the price of the Epi-Pen, not its efficacy.

So if we could have come up with a reasonable guesstimate, I would have submitted it. But I thought it was about 25 packets, but my wife thought it was at least twice that.

I contacted my local CVS, where most, if not all of the prescriptions were filled. But they only had the records for the past two years. I needed to call 800-SHOP-CVS. After being on hold forever, I got someone who didn’t really understand my ask initially.

Eventually, I was transferred to someone who knew what I wanted. I needed the records department, and they’re on;ly open between 8 a.m. and 4 p.m. Eastern Time, and by then it was 4:45.

A few days later, I called earlier. Still a lengthy wait, but when I got to the records department, the person I spoke to knew I needed purchases between August 24, 2011, and November 1, 2020. She was trouble finding my daughter’s records, but we figured out that the records were under MY name as the insurance holder.

The records took less than a week to arrive by mail.

Vaccine incentive: donuts to college

free stuff

I’m OK with the COVID-19 vaccine incentive programs. So is the White House. The programs range from free donuts and beer to lottery tickets to select free passes to attractions.

Still, I was just a tad put off by the fact that many of the incentives were only for the newly vaccinated. (Sidebar: a previously resistant local columnist got kudos for changing their mind and deciding to get the vaccine. Meh.)

Yeah, yeah, getting the injections as soon as I could was its own reward. Second Pfizer shot on March 24, for the record, back in the old days when people were actually in line to receive it.

So, I’m pleased that New York State is offering a Vaccination Scholarship Incentive. “Enter your vaccinated 12-17-year-old for a chance to win a full scholarship to a SUNY or CUNY school.” I believe we have one of those in our household. Yup, under 18, vaccinated the second time in mid-April. So I signed up.

“Get a shot to make your future. New Yorkers age 12 to 17 who get vaccinated (or already have gotten vaccinated) can enter for a chance to win a 4-year full-ride scholarship to any public college or university in New York State. Fifty total winners will be chosen at five random drawings. The scholarship includes full tuition, room, and board, as well as an allowance for books and supplies. Parents can learn more here.”

American football

Oh, and here’s something potentially for me, as noted in the Boston Globe: “Starting June 1, you could score a VIP trip to Super Bowl LVI along with your COVID-19 vaccine at CVS. Woonsocket-based CVS Health announced… that eligible customers who received or plan to receive a COVID-19 vaccination through one of their retail pharmacies will be able to enter into their new sweepstakes program for a chance to win one of more than a thousand prizes. The winners will be chosen through weekly drawings and grand prizes over the next six weeks.”

Note to self: go to this site today. I’m going to the Super Bowl! OK, probably not. Where IS the Super Bowl next year anyway? Near Los Angeles.

Regardless, I hope this governmental and corporate bribery of the citizenry works to get more shots in arms.

In search of the COVID vaccine

not throwing it away

From day one, I’ve wanted it. I’ve been in search of the COVID vaccine since its availability was first announced.

My wife, the teacher, was the first one in the household to get a shot at the very end of 2020. She received a letter from her school system then got on the state site. As she put it, she got her two doses on national holidays, Sundays, February 14, and March 7, at SUNY Albany.

A couple of weeks later, around January 12, they let the 65+ on the list. As my wife warned me, the slots filled up quickly. Sometimes, while I was in the system and clicked on a date, by the time I finished, the slot was already gone. Finally, I got one. March 31. Ugh. At least it was also at SUNY Albany.

Friends of mine got appointments in Utica, 95 minutes to the west of Albany. Or Plattsburgh, about 2.5 hours to the north. Or White Plains, two hours to the south.

Consumer Value Stores

But then some of my buddies who were 65+ started getting appointments in the area. I didn’t try Walgreens because one had to register as a member or some such. But I did go to the CVS site, and it was always full locally, at least when I had checked.

On the morning of Tuesday, March 2, I woke up at 5:30 a.m. No useful info was accessible on the CVS site. At 6 a.m., there were – suddenly, as a host of angels singing Hallelujah, even during Lent – available appointments! And I got two, the first on March 3, a/k/a, the very next day, with the other about three weeks later!! (Worthy of at least two exclamation points.)

Later that day, a volunteer from the Albany Public Library called me to ask me if I needed assistance tracking down a vaccine. Twenty-four hours earlier, I would have screamed, “YES, HELP ME!” BTW, I understand that the Schenectady library is also reaching out to its constituents, and I think it’s grand.

I got to the store on Central Avenue in Albany, a 10-minute bus ride, and about the same time on foot, at 9:35, 25 minutes before my slated appointment. The guy in front of me was scheduled for 9:45. I was feeling bad for the store employee who was both working the registration table AND running the front store register. (Eventually, they got someone to just work the vaccine table.)

Following the blue tape, I stood in line. Soon, there were about a dozen people behind me. Then at 9:55, two guys appeared from the pharmacy area and started administering the Pfizer shots. Didn’t hurt at all. I shopped around the post-vaccine area, then chatted with another recipient. She admitted that she was one of those people who checked the various websites for hours each day looking for her “golden ticket.”

One more time

The next day, my wife said that friends had alerted us that the Washington Avenue Armory site was now accepting all eligible folks from the whole city. They weren’t just inoculating selected ZIP Codes that included where my wife used to live (12206) but not where we live now, a half dozen blocks away. This would be for our daughter who has a note from her doctor specifying her underlying conditions.

Early on, I was making zero progress. Then I got an email from the city of Albany school district with a direct link to the state site, and the Armory had been added to the list. Bottom line, my daughter has an appointment in mid-April.

But I COULD have gotten her a shot at a pop-up in Albany on March 6. At first, it was for 65+ only, but when they had vacancies the day before, they expanded the pool. By the time I found out about the change, all of the slots were gone.

The COVID vaccine rollout has been like the wild and wooly west. Some folks actually feel guilty for receiving their shots when others have not. While I appreciate their sensitivity, I would never fault them for getting protected. This process could have gone better at the outset, but as some musician once wrote, “It’s getting better all the time.” A Hamilton song also seems appropriate.

The Selma Diamond voice at the CVS

“They need to put everything back the way it was!”

The CVS in my neighborhood I have visited many times. There is a regular set of registers near the entrance/exit of the building, plus a pharmacy register in the back.

I had noticed that some items had been rearranged the last time I went there. Some short woman with one of those carts one can purchase was muttering that she can’t find anything. I tried to commiserate with her; “Yeah, they have moved some items around.” She snapped back, not really at me, but very loudly, “And I DON’T LIKE IT!”

Then she, standing a good twenty feet away from the pharmacist, started berating him , demanding that he help her find some items. This went on while he was dealing with another customer in front of him.

I meandered to the front of the store to get an item. There were two staffed registers. There was a customer at one, and a customer who had just finished his transaction. The two people in line PLEADED with the sales clerk momentarily without a customer to PLEASE help that woman find what she wanted, forgoing being checked out sooner.

“I’m never coming back to this store ever again,” she snarled. I’m sure more than one person in the building was thinking, “Is that a promise?” Then she upbraided no one in particular, “They need to put everything back the way it was!”

And that clerk did help her, but evidently she needed another item. She barks again at the pharmacist, insisting he take care of her, because she was next, though she’s STILL 20 feet from the queue. The front-store clerk returned, as he could hear her kvetching again.

It only occurred to me later that she sounded rather like the late actress Selma Diamond, only five times LOUDER.

Leaving the CVS, I run into one of my friends from my former church on the way to the laundromat. I related the CVS story. She acknowledges that she too has a phobia of going to a store and not being able to find anything. But, I noted, “you just leave, not make everyone around you miserable.”