Wednesday, January 23, 2019

That time I didn't pay $1165 for medication

File this one under: Fun. With. Insurance! We switched insurance companies at the start of the year, and I recently had to get more scopolamine patches for Max. Worn behind an ear, they're typically used for sea sickness; one side effect is that they dry up your mouth, so they help with saliva control for people with cerebral palsy. Our company offers us a care coordination company to help navigate insurance and health issues, so I asked a rep to look into the cost. The response I got: $1165 for a three-month supply. Which used to cost me $80.

Wha? Was she sure? That was for the generic?

Yep. She'd called once more to check, and yes, for the generic.

After I pointed out that something was really, really wrong, I learned about GoodRx, a company that saves people money on prescriptions. Do they ever: If I signed up for their Gold Plan, a three-month supply of patches would cost $117.31 plus $10 per month for a membership (the first month is free). The only downside was that the money wouldn't go toward our deductible but because I wasn't sure we'd hit that—and because there was no way I was going to shell out $1165 for a three-month supply to anyone—it seemed like the best option. 

And then: the extremely dedicated rep called our insurance company yet again and found out that the actual true real not kidding cost would be $330—$835 less than what we'd originally been told. Her guess was that the reps had run the information through the system before Max was eligible for a refill and hadn't thought to point that out. Oopsie! I still decided to go with the GoodRx option.

The morals of the story:

• If a prescription seems way too expensive, there actually could be a mistake.
• Can I tell you how many times insurance staffers have made mistakes over the years? No, I can't, because there are too many to count.
• Don't trust the reps who pick up the phone when important cost or provider information is involved; ask to speak with a supervisor.
• Insurance companies are not good for your blood pressure.

That is all.

Also check out:
Getting insurance companies to pay for children's therapies: 9 hacks


  1. I can vouch for goodrx as well. During an insurance switch, we had to pay out of pocket for a medication that cost $240 a month. By using goodrx and going to the pharmacy across the street, we got the same script for $27.

  2. Oh my word, makes me so thankfully for our NHS here in the Uk. Can totally understand why some people cannot afford to refill prescriptions, makes you wonder how much money these big pharmacy companies are making.


Thanks for sharing!

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