Prescriptions

[bobquasit]

I found out something interesting a while back. I was picking up some prescriptions at CVS, and was shocked when the price turned out to be double. The last time it had cost $20, and now it cost $40.

I asked the pharmacist to check, and he said it was the correct price. Maybe our insurer had changed the formulary, he suggested, or raised our prescription co-pay.

Either way, it really sucked.

But it turned out that the problem was that the doctor had written the prescription for 31 days. Our insurance company assumes that all prescriptions are for 30-day increments, so that extra day meant we were charged a complete extra co-pay.

In other words, we paid $20 for the first 30 days of medication, and then another $20 for just one more day.

We couldn't get our money back on that one, but when the doctor made the same mistake the next month (although we'd told him about the problem), I caught it at the register and had the pharmacy give us just 30 days of medication instead.

I wonder how often that sort of thing happens?

Comments

[moonlitmagik.livejournal.com]

i have never heard of that.. your doc must be retarded or something lol.. but i never thought about it and it does make sense in a sick way

[ocean-state.livejournal.com]

That's just bizarre. My health insurance is both costly and crappy, but as far as I know they don't have any rules about the time increments of prescriptions. I have filled three different prescriptions in the past three months (all for the same condition), and each one had up to 5 or so refills, which could be filled up to one year from the date of the original scrip. I only paid the co-pay for one bottle each time, which was $7, $50, and $0 respectively. (Insurance paying for all of the medicine?! What is this world coming to?! ;p)

Also I think that doctors, even the well-meaning ones, are complete fuckwits when it comes to writing prescriptions. E.g. the patient in poverty, who is receiving health care through a community clinic and the doctor damn well knows it, is prescribed $175 dollars in prescriptions that xe CAN'T AFFORD TO FILL.

[bobquasit.livejournal.com]

Well, I think the thing is that for no sane reason my insurer - or possibly the third-party company which administers prescriptions for them - defines a month as a period of 30 days. So if a doctor specifies a 31-day prescription, the patient is royally screwed.

Insane medication prices and policies are of a piece with other major problems which cripple the American healthcare system. I suspect we'll see a major crisis - and I mean a MAJOR one - within ten years.

Not that there's anything that any of us can do to prepare for it...

I'm impressed by your insurer's prescription policy, incidentally.