I missed a payment, so my benefits lapsed. However, I haven’t met my Rx deductible yet—does that make a difference? I’m new to insurance and have watched the BDG video, so I have a basic understanding. I recently got a new prescription, but the pharmacy is having trouble verifying my insurance. I have a payment scheduled, but the insurance representative I spoke with said it won’t go through until tomorrow, leaving my account inactive for now. Since I haven’t reached my Rx deductible, I understand that I’ll have to pay the full cost for my medication. If I need to pick up the prescription today and will be paying out of pocket anyway, does it really matter that my benefits aren’t active until tomorrow?
Missed a payment so benefits lapsed, but haven’t met Rx deductible yet, does it matter?
It sounds like you’re in a bit of a tricky situation. Since your insurance benefits have lapsed because of the missed payment, you won’t be able to use your insurance to help cover the cost of your prescription until that payment goes through and your benefits are active again. Since you mentioned you haven’t met your Rx deductible yet, even if you had your benefits active, you would still be responsible for the full cost of the medication until you hit the deductible.
If you need to pick up your prescription today and can’t wait for the payment to process, you may indeed have to pay out of pocket for it. It might be worth checking with the pharmacy to see if they can provide you with an estimate of the cost without insurance. Additionally, if you explain your situation, they might be able to work with you on the timing of your payment or provide alternative solutions.
Once your payment goes through and your benefits are reinstated, you could also reach out to your insurance company to clarify your coverage and ensure you understand your deductible and benefits going forward. Good luck, and I hope you can get your prescription sorted out!