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Wednesday, June 10, 2015

Good News…but WTF?


Good News…but WTF?
 

For a number of years, I have been filling a prescription at a local pharmacy.  The prescription is for 20 pills to be renewed every three months. 

The first few years, the twenty pills cost me about $50.

About three years ago I went for my refill, paid only $25 and thought “Great, the price has come down.” Then I got home and realized they only gave me 6 pills.  I drove back and questioned them why they only gave me 6 pills.

“That’s all your insurance will cover.  If you want all twenty pills you have to pay extra.”

“What?  Suppose I needed twenty pills for a life saving issue.  You would still only give me six pills?”

“Well, that is all your insurance will pay.”

“That is disappointing, but shouldn’t I have the option to pay for all the prescribed pills…you know, just in case I wanted to live beyond the six pills?”

“You don’t need these pills to save your life, they are considered to be recreational.”

“Well maybe I’d like to be recreational the full amount of the doctor’s prescription!”

“Certainly sir, but the pills are expensive if you want the additional 14 pills.”

“How much?”

“They will cost you $550.”

“Please fill out the whole prescription, I’ll pay the balance.”

Now for the next few years every time I go to the pharmacy they only give me 6 pills and I have to argue with them before they let me pay for the other 14 pills; and for some insane reason I always have to come back the next day for the other pills.

Today I went in for a pick-up, and as usual they only filled it for 6 pills.  I told them in my most exasperated voice, I would pay the uninsured amount to get the full prescription.

“Yes sir, that will be $900.”

“WHAT? Six months ago I only paid $550.”

“Just a minute sir let me double check.”

“La la la dee dee da da la la.”

Fifteen minutes later

“Sir, that price is correct, but if you want you can just pay $25 for the six pills and then come back in 25 days where your insurance will allow you another 6 pills for $25, but they will only subsidize 6 pills every 25 days.”

“Wait.  You mean the insurance will cover all the pills in the prescription, but they will only pay for 6 pills in 25 day increments.”

“Yes sir, come back in 25 days and I can give you 6 more pills for another $25.”

“So for the last three years I have paid $550 three to four times a year when I could have bought them for only $25 every 25 days in increments of 6 pills?”

“Yes sir, you have the option of buying them 6 pills at a time every 25 days at the subsidized price, or you can pay for all 20 at once, but the insurance only will cover 6 pills.”

“Well that is good news; it will save me lots of money… I only wish someone would have explained this option to me six thousand dollars ago!!!”

“I guess they figured you didn’t want to make the extra trips.”

Now I don’t know whether to be happy or pissed off. 

I saved $550 I was expecting to have to pay, but I can’t stop thinking about the six thousand bucks I paid over the last three years which I could have saved by just making a few extra trips to the pharmacy.

I just decided…I’m pissed off!

20 comments:

  1. I'm pissed off too. For you of course, since this has nothing to do with me.
    Isn't there any way you can get at least some of that money back? Go to the pharmacist and make a big fuss about why you weren't told ALL the payment options in the beginning?
    That's an awful lot of money.

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  2. My mind boggles at what a recreational pill might be ... Seriously though, that's outrageous and I'd certainly be wanting some money back. It makes me grateful yet again that we have the NHS here in the UK where prescriptions have a flat rate of around £7 each and those on a low income or with certain conditions are exempt from charges.

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  3. Crikey! Thank goodness I live in the UK and because of my age get everything free. I don't agree with that, actually, I believe I should pay something towards the cost but it seems that's not how it works

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  4. Sometimes I really hate the american medical insurance system. Why so expensive?!? No makey sense. Very anger. Much complicated.

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  5. This is why it pays to argue and ask about all of the options. They may not like me very much after i argue with them, but i get the whole story if i keep at it, and it has helped more than once.

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  6. crappy crappy crappy business!

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  7. I learned last year, to my dismay, I must read the pharmacopoeia of my drug plan to see if vital drugs are covered next year, and make my agent find a better plan, if necessary, during that abominable sign up window. Because I did not do it last year, this year I am struggling with blood pressure meds that do not work. Yea, i'm pissed off.

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  8. Get used to it Cranky. We old folks will be paying more and more and more to cover those that don't put into the system. Everything is screwed up. I don't even want to tell you about my insurance this year. Awful.

    Have a fabulous day. ☺

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  9. Glad you got it explained now, but it would have been better before you spent all that additional money. Such a pain with insurance; you got to have it, but what does it really cover?

    betty

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  10. Insane. That pharmacy should be sued for negligence. I wonder if an attorney's letter would produce a "settlement?"













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  11. Those must be some extremely potent "recreational" pills. Crack is so much cheaper--I've heard.

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  12. What are these recreational pills?? I am intrigued.

    I am also intrigued as to how the insurance companies continue to get away with this BS.

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  13. Goodness, those are some expensive pills!

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  14. Insurance covers everything except what you need at the moment!!

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  15. I realize being a pharmacist isn't a bowl of cherries, but seriously? It pisses me that they can't be bothered to explain your options.

    And I'm chuckling that they would use the term, 'recreational drug.' Very discreet of them.

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  16. All right. Let's cut to the chase. Are these pills blue?

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  17. After hearing about this experience, all I can say is: You'd better not go to The Good Feet Store. It cost me $1000, because my husband, when presented with the bill for his shoe inserts, could not say, "No."

    Not that shoe inserts are in any way related to your recreational pill.

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  18. Oh my god!! Just reading that pissed me off too!

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  19. It seems as if I am in continual aggravation with my pharmacist and insurance carrier over my and my wife's prescriptions. It is getting to a 'Doctor's Order' doesn't carry much weight with those insurance folks.

    All this medical stuff is becoming more and more complicated.

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