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Insurance Question

This is going to be long and complicated. Skip if you want.

So late last year (November?) we had to sign my grandmother up for a new prescription insurance program. My mom and I sat down with her, checked all her prescriptions and many of the different options available and settled on a program to sign her up for. Instead of just relying on the printed/web information, we telephoned the company and confirmed with a representative that all her medications were covered in some form in their policy.

Flash forward to February. Her new policy is in effect and its time to get her previous prescriptions renewed. My mom filled out the order form with all 4 medications listed, had my grandmother sign it, and mailed it in, under the assumption that all 4 were covered. I’m sure you see where this is going. She gets her drugs along with a bill and a letter. One of her drugs was not covered, but they were sending a 30 day supply and to contact her doctor and the company to find an alternative. Of course they also billed her full price for that one month supply as well.


Now here is where the details get murky. My grandmother claims that she called the company and asked to see if she could return the uncovered (and completely unopened) medication as she did not want to pay that high cost. (It used to be $10 under her previous plan and she was charged over $150.) She claims they agreed to send her an envelope to mail the drug back in and once she does that the charge will be removed from her account. No envelope ever arrived.

Flash forward to today. She gets another billing saying that her $150 charge was past due and asked me to call the company on her behalf. I call, go through all the details, and they say that they never agreed to let her return the medication; that because they have the invoice with her signature asking for the medication, that she was liable for the full amount. They also claim that a conversation had occurred between my grandmother and them, offering my grandmother to switch to a different generic form of the same drug that was covered and that she denied it. I’m not sure if this conversation occurred (my grandmother has no memory of it, but that’s not a good barometer anymore), or if it occurred before or after the drugs were shipped to her home. The company representative said that there is absolutely nothing they can do lower or delete the charge.

Now my grandmother is very insistent that they had agreed to let her send the drug back and that she would not be paying this bill. And I’m just not sure what to do, if anything. Unfortunately neither my mother or myself were privy to the phone conversation where she claimed that the company offered to take the medication back. It’s possible that they did offer to take the drug, but never followed through in the hopes of fleecing an old lady. But it’s also possible that my grandmother misheard/misunderstood the conversation and that no offer was ever made.

So, I guess I’m just wondering if any of you intelligent people have any advice/words of wisdom/frustration gifs that you would be willing to share. In all honesty, I’m not expecting much but figured I’d give it a shot.


Oh, and don’t worry. The medication wasn’t anything absolutely necessary. Just a high dose supplemental vitamin type that her doctor said she could do without.

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