this post was submitted on 09 Dec 2023
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[–] Kalkaline@leminal.space 84 points 11 months ago (2 children)

It's ok when multi billion dollar insurance companies do it when they decide which med they're going to pay for.

[–] Drusas@kbin.social 31 points 11 months ago

I had to go to the ER recently because my insurance decided to stop paying for the higher quality iron infusion formulation and switched to only being willing to pay for the cheapest options. Turns out the cheap, less popular options are more likely to have bad reactions.

Wish I could sue them, or at least have whoever made that decision suffer the pain that I did.

I can at least be somewhat comforted by the fact that that emergency visit cost them a lot more than the usual formulation would have. Try to save money on my health care? Fuck you, too.

[–] Unaware7013@kbin.social 30 points 11 months ago (1 children)

Yeah, just as long as the government keeps its damned hands off my medicare!

[–] thefartographer@lemm.ee 14 points 11 months ago (2 children)

My insurance company is my friend! They make the pills that make the sad go away cost less.

[–] Drusas@kbin.social 21 points 11 months ago

Insurance actually generally increases prices. Then they "negotiate it down" to regular prices.

[–] Alteon@lemmy.world 11 points 11 months ago* (last edited 11 months ago) (1 children)

They are not your friend. They are the reason your pill costs so much. Pharmacist can actually charge less for them if you say you want to pay in cash - you often pay MORE to use insurance on a lot of prescribed medication. They legally can not tell you that.

Read up, it doesn't hurt to talk to pharmacist https://www.pbs.org/newshour/health/why-a-patient-paid-a-285-copay-for-a-40-drug

[–] MrQuallzin@lemmy.world 5 points 11 months ago (1 children)

I'm always curious when this type of story comes up. Is it locale based? Certain states doing funny things? Certain chain pharmacy practices? From my almost 10 years experience as a pharmacy technician in Oregon and Washington, I still have yet to see the actual cash price (not wholesale price) be cheaper than insurance.

They legally can not tell you that

Got a source for that? Absolutely not true.

If you go to Walgreens, your prescription leaflet specifically tells you how much you "saved" over the cash price. That cash price is the most expensive price you could pay for the medication. Cash price of your drug is $297? If insurance pays nothing, you'll pay $297. Ask to pay cash and you'll pay $297.

Now there are some chains that do have a list of medications that they do have cheaper (Example is Walmart's $4 Drug List, or Walgreens' paid discount program), but that's chain specific and the lists are pretty narrow in what's covered. They're loss leaders since they want to fill all your other drugs that aren't on those lists.

The other alternative is Discount Cards. Can definitely save money over insurance prices, but it's hard to know what those companies are doing with your data. You're giving a random 3rd party access to your health information. They'll give you a discount then turn around and sell your information to the highest bidder. Unfortunately sometimes a pharmacy will run your claims through one without telling you when you ask to pay cash (Some give kickbacks to the tech/pharmacist).

None of this is to say that I like the prices of drugs. Drug makers and insurance companies artificially raise prices and tell you you're getting a good deal on your "million dollar" medication.