27 Jan, 2019 → by ClaimboUser495265
Resolved: Over 1 month later and still no action on Prior Authorization

1

Update by user Jun 14, 2019 So far so good. I am still receiving the medicine at the discounted price. Original review posted by user Jan 27, 2019 I have called Wellcare about 30 times now, ever since the day after Christmas, about a Prior Authorization for a prescription drug of mine. It's my Medicare Part D insurance company for 2019. I had Wellcare one time before, and was actually pleased by it. But that was because I didn't have to use their customer service even once. I had to this time, and it's been a total and complete disaster for me in every way. First off, their call center is not located in the US, but in the Philippines. Yes this is a Medicare Part D insurance company we're talking about here, all due to outsourcing. Their customer service reps either don't know what they're doing, don't understand you, or, this is the most logical option, they know what they are doing, and are intentionally trying to deny your prior authorizations. And that is why they do so. I probably stood absolutely no chance in the 1st place. They are very rude and condescending as well. The female pharmacy technician is especially bad. She sounded like she could care less about my situation. I have had them fax my Prior Authorization requests to my physician at least 3 times, and it took them over a month only for them to still deny me in the end. I also have appealed it twice. I still don't know what is going on. I received a paper from Wellcare about the denial. They told me that the medication wasn't on their formulary. They told me that it was a "brand name" medication, and not a "generic" one. Also, they had the dosage amount listed incorrectly as well. Now I honestly don't know if my physician had put the "brand" name of the drug instead of the "generic" name, and she is not really receptive to phone calls, deferring to the LPN instead, who told me she doesn't know. That is possible. Maybe she put the whole daily dosage, instead of half the dosage as well. I won't know until my next appt. Feb 6. That is a long time to have to wait, especially when I need my medication really today. I wish I had never signed up for Wellcare, but to do that, under US Medicare Part D law, you have to do so on/before, or you're stuck with Wellcare for the entire year of 2019. And you have to make your decision before Dec. 7 as well. Others have complained about this supbar customer service as ell. From now on, beware of any Medicare Part D insurance company that requires "Prior Authorization." Not only Wellcare, but all others as well. There are a ton of people in the same boat I am currently in. Sad but true...
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