Thursday, October 1, 2009

Ouch.

Almost two months since my last post.
This is because I have hated my job so much I can think of almost nothing else.

Today I simply have a rant about insurance companies. Even people lucky enough to have insurance get fucked regularly.

I am taking a common anti-anxiety/antidepressant (SSRI) . It is a brand name drug so according to my insurance plan it is $35.00 each time I fill it.

Here is what my insurance company says:
"Retail Pharmacy Program:
• PPO: $10 generic/$35 formulary brand-name per prescription/50%
coinsurance ($45 minimum) for non-formulary brand-name drugs.
34-day maximum supply on initial prescription; up to 90 days for
refills with 3 copayments"

So it is $35.00 a month. No matter how much the drug costs, or how much you get -- as long as it is only a 34 day supply.

So my doctor, being the kind and generous person he is, gives me a script for 30 20mg tablets, which I then cut in half, so I have two months of pills for $35.00.

Well the insurance company got wise. Yesterday I went to get my meds and the girl said it was $70.00 WHAT!?
So she says, "Well is it probably your deductible." No, it isn't -- I don't have a deductible because all I get is meds and twice yearly Dr. visits... couldn't touch a normal deductible until halfway through the year. So she says "Well retail price is $104". Seriously? So I am paying $250 dollars a month for a savings of $34 on my meds!?

Wait, this is for two months worth, 60 days. So I am being charged two co-pays. If I was on twice the medication I would pay only $35.00. Right that makes sense. Oh, and actually it is only a savings of $17 per month for my $250. Cool. Thanks, Insurance. Gold star for you.

So really what is happening? Well the drug companies and the insurance companies and the pharmacies (as entities, not as the individual pharmacists) all get a little slice on this. The insurance company gives you a discounted price so you use the expensive drug the pharma companies make, but makes sure you pay every month for more pills, and the pharmacy gets more foot traffic for people coming in monthly. Win, win, win...until we get to the consumer.

Yes, I know, it is stupid for me to bitch about it. I am lucky to have a job and insurance. But remember this: I am saving 32% on my meds. And paying 12% of my salary for that.
Better to get one of those pharmacy savings cards, really.

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