So, when I called OptumRX to refill my prescription on Thursday, the lady told me that insurance denied coverage. After asking a bunch of questions to try to figure out why, she finally told me that my account has Medicare as my primary insurer. Umm, I've never had Medicare in my life. She said I would have to call my insurance and request, "blah, blah, blah," I can't remember what she said my insurance needed to do.
Anyways, I called UHC and I explained that OptumRx is showing my primary coverage as Medicare even though I've never had Medicare. The lady finally figured out that I was somehow switched back to my parents plan, which is also UHC, not Medicare. Thankfully, she knew the "blah, blah, blah," she was supposed to do and told me that it would take 24 hours to take effect on OptumRX systems. She also had no clue how or why I was switched back to my parents' plan.
I waited a day and called OptumRX again. This time I began by reading off my member ID number for my insurance to make sure that's what they had on file for me. It wasn't and it wouldn't let the guy change it manually in the system. He also told me I would need, "blah, blah, blah," and I told him I already had my insurance do "blah, blah, blah." So, he tried to get ahold of the "Resolutions Team." There was a long wait line because all of the call centers on the east coast were sending their calls to the west coast, so I had to wait over two hours for someone on the Resolutions Team to call me back.
Finally a Resolutions Specialist called me back and was able to setup my correct insurance on file. She also didn't know why or how I would have been switched back to my parents' insurance. At least, she was able to process my order and refill my prescription.
All of this prompted me to login to my UHC account to look at my claims. It turns out the last claim my insurance has for Cimzia was back in October. My mom is supposed be looking into seeing if my refills since then went to her claims. It appears I was switched back to my parents' insurance a while ago and it was only brought to my attention now because they denied coverage. Insurance companies are so stupid, but I can't really hate them because they save me so much money.
