Kelly, a patient living with a chronic disease diagnosis, was recently having trouble obtaining the specialty medication that she has been taking for many years. Kelly has used a large mail-order pharmacy for the past four years to fill her specialty medication. When she went to refill her script this time around, the pharmacy abruptly informed her that they could no longer accept her insurance and referred her to a national specialty pharmacy chain instead. Feeling overwhelmed and out of sorts, Kelly could not seem to figure out the ordering process at the large pharmacy chain or how to get in touch with someone over the phone to request a medication refill. After a string of long wait times and frustrating phone trees, Kelly decided to try a different option. Desperately wanting to speak with a real person who was located close to home, Kelly started digging and found the business card of a pharmacy Liaison located at her local hospital that had introduced herself to Kelly a while back. She called the liaison’s direct number listed on the business card and was able to talk to her liaison right away and explain the current situation she was in. After talking for a while, Kelly’s liaison told her she would do some investigating and get back to her with a solution as soon as possible.
After a few hours of research and communication with Kelly’s previous pharmacy, the liaison called her back and told her that her health insurance plan was actually contracted with the hospital specialty pharmacy so that she could fill there and that she could get financial assistance through two different foundations to cover her $380 co-pay. Kelly was delighted with the outcome and immediately felt a sense of relief knowing that everything was taken care of and she wouldn’t have to worry about her medicine going forward. Kelly was able to continue on her specialty medication with no interruption and continue to live a healthy, fulfilled life.