I hadn't read her post until now. GHPP is a state funded program, and due to the budget crisis, has cut back on staff, causing longer delays in response time and payments; but, as far as I've experienced, there hasn't been a cut back on what's been covered. Again, I'm not dealing with any other insurances other than Medicare and GHPP, perhaps that was the reason she was having trouble? Don't know really. All I do know is that I've been fully covered, even with the cut backs.
Now the issue with Tobi: I've only been on Tobi once, a while back. I remember having to go through a separate special pharmacy to get it, but still, it was covered. Maybe her center didn't have access to that pharmacy?
And remember, GHPP doesn't pick up deductibles or co-pays, so if you have to pay $500 out of pocket before the primary insurance kicks in, GHPP won't pay that, ever. Or, if your other insurance issues a co-pay of $20 per rx, GHPP also does not pay that, ever. That is still out of your own pocket. There is no deductible with Medicare.
She is correct in that you need to use a pharm that is agreed upon by GHPP and who will accepts GHPP terms of payment; however, your CF team (Social Worker) should be able to provide you with what pharmacies they've used that are approved.
Are you in Northern or Southern CA? What center do you go to, if you don't mind me asking? If you don't want to post, you can IM me.
Again, I hope that helps. And, yes...DO talk with your center about this, that is part of their job is to help you get what you need.
Best Wishes