I contacted the customer service dept. Of PJP Health Agency, but to no avail. I used to have Blue Cross, but when I lost my job I switched to insurance offered with PJP Health Agency. I went to pick up my prescription and I was told that PJP Health Agency is not covering this medication and I have to pay $185 which is outrageous. The agent I spoke with said I would have a $30 co-pay.
This is my first dealing with PJP Health Agency. I spoke to a Customer Service Rep and they again said all I could do was file an appeal, which I did over the phone. They said it would take 7-10 days to hear back and if they denied my appeal, they said I could file another one. I told them this was ridiculous. I am not waiting to file another appeal. It is not fair that a patient should be forced to pay such a high price for a prescription when the agent said the co-pay was $30.
PJP Health Agency is a nightmare to deal with. They want to play doctor and they are not physicians. They have no right to dictate to me what medication I should take and then refuse to cover a medication when they said it would be covered with a co-pay. I have reported them to the Better Business Bureau. PJP Health Agency doesn't have any problem with collecting the premiums, but they seem to have a big problem in paying out on prescriptions.
The first time I go to get a prescription they would not cover at all, even though Blue Cross covered it prior to this. The damage is I cannot get my medication because of these people. I am sure this is only the beginning of things they refuse to pay for even though they have no problem collecting my money every month.
The agent I spoke to was dishonest with me. Why would he promise me a $30 co-pay knowing they would not cover the drug? I canceled my policy and I am looking for other insurance.
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