Jack often struggles with his breathing. Too many years of smoking plus bad allergies to dust and pollutants in the air have caused him to develop a chronic respiratory condition, called COPD.
To help, Jack’s doctor prescribed him with a medication in the form of an inhaler. So far, it’s been successful in helping him control his condition and preventing flare-ups. In addition, it makes sure symptoms—such as coughing, wheezing and shortness of breath—don’t occur.
Sudden Illness Brings a Close Call
Typically, Jack gets his inhaler by simply calling his pharmacy each month to have it refilled. Recently though—since his condition makes him more prone to illness—he became sick and developed pneumonia in his lungs. This infection caused a serious flare-up of his COPD symptoms.
To cope, Jack found himself reaching for his inhaler more than usual. He needed it to be able to breathe while he was trying to recover. But this also meant his inhaler was being used up faster than normal, and he realized it was starting to run out.
A bit worried, Jack called his pharmacy to refill it, as he normally would. However, during his call, he learned he wouldn’t be able to get a new inhaler for another five days. Jack was afraid this was too long to wait—if his symptoms got worse, he’d need to go to the hospital.
Caring Help is On the Way
Fortunately, Jack has high-quality pharmacy benefits through Meritain Health® Pharmacy Solutions (MPS). He reached for his member ID card and quickly dialed the number on the back.
Here, he was connected to a skilled CARE Program representative who listened carefully as Jack explained his situation. Right away, they sprang into action with ways to help.
As a first priority, CARE wanted to make sure Jack could get his medication quickly. Working with his pharmacy, they were able to secure permission for an override to allow his prescription to be filled immediately. In fact, Jack could pick up his inhaler within an hour!
But, as a further step, a manufacturer copay card was also provided to help lower prescription costs. This assisted Jack in bringing his out-of-pocket costs from $75, down to zero.
Jack is so grateful for the extra guidance and support he received when he needed it most. Today, he’s on the mend and breathing much easier! And he’s happy for prescription benefits he knows he can count on.
This story is based on an actual member experience. Names and information have been changed to protect the member’s privacy.
This communication is intended for informational, promotional purposes only. The reference to previous outcomes made as a part of this communication does not guarantee success or similar outcomes in any new or future cases, as the result of each case depends upon many factors, including but not limited to the facts of each case. Any actual savings will vary based upon numerous factors, and neither Meritain Health nor its affiliates guarantees any level of savings.
