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