One Call Helped Frank Lower His Drug Costs

For Medicare member Frank Pecora, making a call to the health plan’s Customer Care team meant finding medications he could afford.

The 75-year-old is one of thousands of members who call the Customer Care number on the back of their membership card and benefit from the expertise offered by customer care advocates who answer questions on everything from medical claims to prescription refill costs.

Connecting With Customer Care

Frank, who recently joined as a Medicare member, said he was surprised after he refilled two of his prescriptions for the first time and was told he had to pay $192. Frank was unable to afford it after paying $20 on his previous insurance plan.

That’s what prompted him to call Customer Care, where he connected with Customer Care Advocate Stephanie.

Stephanie talked with Frank and helped him to understand the details of his insurance coverage, including what to expect from the costs associated with the deductible to his prescription plan coverage.

Because Frank was on a high-deductible plan and his Symbicort^® medication fell under a higher tier level, Stephanie explained that he would have to pay his deductible first, which included the $192, and then once that’s reached, he would only have to pay the copay for his medications.

“My number one goal when talking to Frank was to find him alternative, more cost-effective medications,” said Stephanie. “Taking the time to listen, educate our members, and find solutions provides them with a sense of relief. We want them to know we are here to help them access affordable care.”

Saving Money With Lower-Cost Alternatives

Stephanie was able to find Frank alternatives to his Symbicort and albuterol medications at a lower tier level that were comparable to what he was taking, and more affordable.

“My doctor agreed that the alternate medications would be fine, and I was able to get new medications that were actually less expensive than what I had been paying out of pocket,” Frank said.

Now, instead of paying $192 a month until he met his deductible, Frank only pays $3 a month, which he says is even more affordable than what he was paying before.

“Stephanie made me a happy camper. She took her time with me, answered all my questions, and took care of everything I needed. I couldn’t ask for anything more than that,” says Frank.

Helping our members access care that’s as affordable as possible is critical to our health plan’s mission. Stephanie says she isn’t surprised Frank was pleased with the outcome of his call.

“Whenever you give someone news about potentially saving money, they are a very happy person, especially for our Medicare members who may be on a fixed income,” Stephanie said. “In Customer Care, we do all we can to help all our members get what they need and stay healthy at an affordable price.”

Hear how Frank Pecora was able to find lower-cost alternatives to his prescription medications with one call to Customer Care.