K P S Health Plans Reviews (1)
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K P S Health Plans Rating
Description: Insurance - Health
Address: 400 Warren Ave, Bremerton, Washington, United States, 98337-1487
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+1 (360) 698-0982 |
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Review: I have been waiting for over a month for them to fix my online account so that I can access all the information without error messages coming up. I am also upset that a medication (Cymbalta) for which there is no generic available but which has proven to be very helpful to me for several years is requiring pre-authorization, is being restricted to just a 30 day amount, and is costing me a much larger co-pay. Desired Settlement: Fixing my online account so that everything functions and is available to me, in particular the "Pharmacy Tool Box," and also not penalizing me by the medication I have been prescribed and which has been helpful for several years when there is no generic version available. I wish for that medication to be available to me in a 90 day amount, like many other medications, and to cost me the same lower co-pay amount as other medications. Note: I take this medication for a common condition and have tried many other medications for it but have found no relief from them.
Business
Response:
Initial Business Response /* (1000, 6, 2013/11/15) */
Regarding on-line access issues:
We regret that the member has experienced technical difficulties with MyKPS web-based applications and apologize for any inconvenience.
Our records indicate that the issue has been resolved as of November 12th.
Regarding pharmacy benefit comments:
KPS adheres to industry practices regarding pre-authorization requirements for pharmaceuticals. These requirements exist for reasons of efficacy, patient safety, and waste-reduction to control cost.
KPS has allowed a one-month pre-authorization override for the convenience of the member in this matter but is unable to comment in further detail so as to protect the privacy of the member.
The pharmacy benefit design (including copayments) is part of the medical plan that the employer has requested and purchased from KPS.
Additionally, the medical plan has been appropriately filed with the state regulator and cannot be unilaterally altered by KPS.
Concerns or questions regarding the medical plan design, such as copayments for a pharmacy benefit, might best be directed to the employer's human resources area or benefits committee.