Prescription reimbursement problems plague family

July 20, 2012 3:07:47 PM PDT
A local woman had insurance but yet she couldn't get her prescriptions covered. So she turned to the ABC11 Troubleshooter for help.

The whole thing has to do with COBRA benefits. Once Debbie McKnight and her family made the switch to COBRA, they had problems getting reimbursed for their prescriptions, which added up to about $900.

McKnight had to pay out of pocket until her insurance reimbursed her.

"I just didn't have that much cash," said Debbie. "So, when I had talked to them, they told me that once the COBRA was back in full force that I would be reimbursed from everything."

When Debbie's husband left his job in November, they continued their health insurance through COBRA. The process took several weeks and once everything was in place, Debbie says she filed her claim to get reimbursed with the prescription company Express Scripts.

"I called and they said they haven't found it," said Debbie. "They told me to call back. So I called back and I kept calling."

At first, Debbie's claim was denied due to lack of coverage. She appealed, and said she was promised to be reimbursed, but weeks later there was still no check from Express Scripts.

"By the end of May, I was getting really irritated. So, I kept calling again and they told me that they had mailed a check on the 24th of May and I was supposed to get it, that everything had processed, that everything was fine," said Debbie. "Well, by the beginning of Jun, I still didn't have any checks. So, I called again."

Debbie kept calling but she still received no money.

"I've been trying for over four months and that is just excessive to try and get reimbursed from somebody because I have provided all the documentation that they needed and wanted," she said. "I was having lunch with my mother one day and she said, 'Well, you just need to call the Troubleshooter.' So I did."

I got in touch with Express Scripts and Debbie got the money she was owed.

"Thank you very much for everything that you did," said Debbie. "I really appreciate it. I can't thank you enough."

A rep with Express Scripts worked directly with Debbie to resolve this issue.

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