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Medical insurance woes - Page 2

post #21 of 35
Thread Starter 
Quote:
Originally Posted by tropicana View Post

 HOLY CRAP. 

You can say that again. Large insurance cos!! I read in an article that they are raising their prices even though the # of people getting insurance is going up. Oh well. I guess we'll have to get it then. I don't have a choice do I?

post #22 of 35

Pharmacies don't care which method you use to pay for your medications. I used to work a lot with insurance. Basically just tell them to compare the cost with insurance and without insurance.

 

Also, some counties are coming out with a Rx card where you can get generics for super cheap. Ask someone in human services at your county office if they are participating. You can use the card even if you have other insurance.

post #23 of 35
Quote:
Originally Posted by tropicana View Post

agree. immune systems are good for colds and flus... which you can easily survive without seeing a doctor, anyway, insurance or no insurance.

insurance is for major illnesses which can strike the strongest immune system, as well as horrible accidents or even minor accidents. i know a family in which the 16 year old broke his arm on a park district swing. they didn't go after the park district, and have insurance covering 80 percent of the cost of the injury... which includes doctor visitS, X-ray, pain killers, cast setting, follow up X-rays, physical therapy and more. they are already out more than $5,000 *out of pocket,* and they aren't done with the injury yet.  (PT continues.) mind you, that's 20 percent of the cost of this injury. so, yes, a simple broken arm that can happen to literally anyone in the family is worth $25,000 to fix. HOLY CRAP. 

update as point of information about the insanity of medical costs and the possibility that this kind of thing can happen to anyone, anytime: i talked with the mom recently, and the kid's injury didn't repair completely with the first surgery, so he had a second, and it's still not fixed right. they are now up to $12,000 out of pocket... which makes this a $60,000 injury... that is still not over with.

 

seriously.

post #24 of 35
Quote:
Originally Posted by tropicana View Post

update as point of information about the insanity of medical costs and the possibility that this kind of thing can happen to anyone, anytime: i talked with the mom recently, and the kid's injury didn't repair completely with the first surgery, so he had a second, and it's still not fixed right. they are now up to $12,000 out of pocket... which makes this a $60,000 injury... that is still not over with.

 

seriously.

I think part of the reason that this kind of thing is so difficult to deal w/ is because we are not accustomed to paying for most of what we have/use what it actually costs.  A lot of food we buy is subsidized by the government so we don't pay the actual price.  So much stuff is made in other countries becuase it's cheaper to make there.  Paying for things like plumbers & electricians, while not typically as expensive as medical care, is also difficult to swallow because we have to pay the person what it actually costs to do the work (including the wages that allow that person to live in this country).  

 

That's all I have time for right now but these are my initial thoughts on this.

 

Sus

post #25 of 35
Thread Starter 
Quote:
Originally Posted by tropicana View Post

update as point of information about the insanity of medical costs and the possibility that this kind of thing can happen to anyone, anytime: i talked with the mom recently, and the kid's injury didn't repair completely with the first surgery, so he had a second, and it's still not fixed right. they are now up to $12,000 out of pocket... which makes this a $60,000 injury... that is still not over with.

 

seriously.

Insane.

post #26 of 35
Thread Starter 
Quote:
Originally Posted by mama24-7 View Post

I think part of the reason that this kind of thing is so difficult to deal w/ is because we are not accustomed to paying for most of what we have/use what it actually costs.  A lot of food we buy is subsidized by the government so we don't pay the actual price.  So much stuff is made in other countries becuase it's cheaper to make there.  Paying for things like plumbers & electricians, while not typically as expensive as medical care, is also difficult to swallow because we have to pay the person what it actually costs to do the work (including the wages that allow that person to live in this country).  

 

That's all I have time for right now but these are my initial thoughts on this.

 

Sus

I couldn't disagree more. Countries like the U.K. and Canada have done it differently. This is big money in the pockets of doctors, big insurance and big pharma.

post #27 of 35

Actually, so pharmacies (and doctors) have a contract with the insurance company to charge a copay regardless of the price of the medication.  It is in the contract along with a set price for each medication.  It protects the insurance company for the duration of the contract (so if the contract says that the ins company will pay $50 for Zoloft, and the patient will pay $30, the pharmacy gets $80 for zoloft no matter what they pay for it ($60 or $120).  The extra money from the copays when there are overages cover the pharmacy when there is a deficit on another med.

 

Some pharmacists will run it without your insurance, but many will not due to the contract they sign.  I have a list of $5 generics from Target, so I check the meds before I take them to the pharmacy to decide where I go.  I use Target for no insurance purchases and CVS for using the insurance.

post #28 of 35
Thread Starter 
Quote:
Originally Posted by anj_rn View Post

Actually, so pharmacies (and doctors) have a contract with the insurance company to charge a copay regardless of the price of the medication.  It is in the contract along with a set price for each medication.  It protects the insurance company for the duration of the contract (so if the contract says that the ins company will pay $50 for Zoloft, and the patient will pay $30, the pharmacy gets $80 for zoloft no matter what they pay for it ($60 or $120).  The extra money from the copays when there are overages cover the pharmacy when there is a deficit on another med.

 

Some pharmacists will run it without your insurance, but many will not due to the contract they sign.  I have a list of $5 generics from Target, so I check the meds before I take them to the pharmacy to decide where I go.  I use Target for no insurance purchases and CVS for using the insurance.

Thanks. Can you get their list of generics online?

post #29 of 35
Quote:
Originally Posted by Neera View Post

Thanks. Can you get their list of generics online?

 

Here is one for Target.  Here is one for Walmart.  Make sure you look at the supply amount to get an accurate picture of what you will pay.  For example, if your script is for ACYCLOVIR 200 MG, 90 caps, you're going to pay $10. 

post #30 of 35
Quote:
Originally Posted by mama24-7 View Post

I think part of the reason that this kind of thing is so difficult to deal w/ is because we are not accustomed to paying for most of what we have/use what it actually costs.  A lot of food we buy is subsidized by the government so we don't pay the actual price.  So much stuff is made in other countries becuase it's cheaper to make there.  Paying for things like plumbers & electricians, while not typically as expensive as medical care, is also difficult to swallow because we have to pay the person what it actually costs to do the work (including the wages that allow that person to live in this country).  

 

That's all I have time for right now but these are my initial thoughts on this.

 

Sus

 

Quote:
Originally Posted by Neera View Post

I couldn't disagree more. Countries like the U.K. and Canada have done it differently. This is big money in the pockets of doctors, big insurance and big pharma.

 

Just because an individual doesn't pay for the services they are receiving does not mean the hospitals, doctors, etc. are not charging someone/an entity the same price/s.  As in, if this person had more comprehensive insurance, it doesn't mean that it would necessarily cost any less.  Just because the UK, Canada, & other places have health coverage (forcibly) paid by all the citizens doesn't mean it doesn't cost a lot.  

 

IMO, you're comparing apples to oranges.  I don't imagine that these places have the malpractice issues & litigation we have in the US (which contributes to sky high malpractice insurance for doctors, etc.).  I don't know what medical schools cost in those areas, so that's another reason why you can't compare them side-by-side.  There's a that factors into the high cost of health care. 

 

Sus

post #31 of 35

What does she have that she's repeatedly being prescribed antibiotics for?

post #32 of 35
Thread Starter 

No strep and strep. The first time she was prescribed for a yet undiagnosed strep. The report was negative.

 

Quote:
Originally Posted by phathui5 View Post

What does she have that she's repeatedly being prescribed antibiotics for?

post #33 of 35
Quote:
Originally Posted by anj_rn View Post

Actually, so pharmacies (and doctors) have a contract with the insurance company to charge a copay regardless of the price of the medication.  It is in the contract along with a set price for each medication.  It protects the insurance company for the duration of the contract (so if the contract says that the ins company will pay $50 for Zoloft, and the patient will pay $30, the pharmacy gets $80 for zoloft no matter what they pay for it ($60 or $120).  The extra money from the copays when there are overages cover the pharmacy when there is a deficit on another med.

 

Some pharmacists will run it without your insurance, but many will not due to the contract they sign.  I have a list of $5 generics from Target, so I check the meds before I take them to the pharmacy to decide where I go.  I use Target for no insurance purchases and CVS for using the insurance.

 

Quote:
Originally Posted by Mulvah View Post

 

Here is one for Target.  Here is one for Walmart.  Make sure you look at the supply amount to get an accurate picture of what you will pay.  For example, if your script is for ACYCLOVIR 200 MG, 90 caps, you're going to pay $10. 

 

This is so confusing to me for some reason. It's never occurred to me to shop around for different prescription rates. I need a tutorial for healthcare I think...

post #34 of 35

Haven't read all the posts but

 

A: Some stores have better prices, and/or "membership" reductions. Shop around, and ask what kind of benefits your local drugs store may have if you get a points card or something similar from them. Also, always ask your doctor if the generic will work for you, and if so, get that prescription.

 

B: If you find somewhere that you can get medicines cheaper, you don't have to lie. Just tell them you'll be paying out of pocket. (I would ask the price first, though, to make sure it is cheaper to pay cash than to pay a co-pay)

 

We don't have a prescription card. so on the rare occasions that we need prescription meds (usually antibiotics or prednisone), I can go to Giant Eagle and get them for free (certain abx) or under $10 with my members card.

post #35 of 35
Thread Starter 
Quote:
Originally Posted by cappuccinosmom View Post

Haven't read all the posts but

 

A: Some stores have better prices, and/or "membership" reductions. Shop around, and ask what kind of benefits your local drugs store may have if you get a points card or something similar from them. Also, always ask your doctor if the generic will work for you, and if so, get that prescription.

 

B: If you find somewhere that you can get medicines cheaper, you don't have to lie. Just tell them you'll be paying out of pocket. (I would ask the price first, though, to make sure it is cheaper to pay cash than to pay a co-pay)

 

We don't have a prescription card. so on the rare occasions that we need prescription meds (usually antibiotics or prednisone), I can go to Giant Eagle and get them for free (certain abx) or under $10 with my members card.

What is a prescription card?

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