Friday, October 02, 2020

4921 - Medicine costs


So I pick up a 90 day supply of a medicine at Walgreens that I take. She said that will be $109. I said wait what? I don't think it was that much last time. She looked it up. $68 last time. And that had been a recent increase from $28. They double-checked and said that's what the insurance company said it cost.



So I logged onto the insurance company site when I got home. I found out that insurance isn't covering any of the costs. I'm just getting the negotiated rate. Which has obviously gone up.

I'd run into this once before with another medication where insurance didn't cover it. Why? Because I'd turned 65 and insurance didn't think I needed to take it anymore since I was 65. Nice, eh? I'm wondering if that's the deal with the medicine I just got. They think I don't need it because I'm over 65.

So I call the insurance company. I got a gal that was a little strange but she spent a lot of time with me so I ignored her eccentricities. Here's what we came up with.

She thought what I got was a tier 3 cost. Should have been $45. She couldn't figure out why it was $109. (Back to my thought that they don't cover it at all.)

So here's the tier system.
Tier      Store          Mail order
1           $2              $0
2           $8              $0
3           $45            $125
4...
5...

So she says, have your doctor call the insurance company precertification line and get it listed as a tier 2, then mail order it, and it won't cost me anything! How do you think that plan will work? I think it might be an exercise in futility. Oh, and BTW, the plans are changing next year.

So I looked for costs online and GoodRx came up with a cost of $33 for a 90 day supply at Costco. I hate the thought of running around to different stores for different meds to get the best price but that's what it might come down too. I'm still not sure how or why GoodRx works except to sell your data.

Retirement is turning out to be more work than working.

***********

Edit: tRUMP and Melania have tested positive for Covid-19.

12 comments:

Elephant's Child said...

Yet another reason I am grateful for our 'socialised' medicine. Most (but not all of our scripts come in at the same price. A few are dearer (dammit). Pensioners and low income earners pay a reduced amount. Our system isn't perfect by any means but medicine and prescriptions are available to almost everyone.

Mike said...

EC - They talk about medicare for all here in the US. I'm not for that. I'm for universal healthcare like the rest of the civilized world. And yes nothing's perfect.

Margaret (Peggy or Peg too) said...

I live this. It sucks and I'm sorry you have to go through this.
As for Mango Mussolini, if its true, I'm sure an injection of lysol will cure him. Also if true I am will to take one for the team and give myself bad juju and hope he's on a ventilator for 12 weeks

Ole Phat Stu said...

I just hope Melania recovers ;-)

Brian said...

I'll be headed to prescription hell in a few years. All these stories are making me worry.

As for the tRUMPs - I feel bad for Melania (a little - she knows what she got into), but Mango Mussolini couldn't be a more DESERVING recipient of the 'Rona. I just hope it doesn't create a sympathy bounce in the polls.

Mike said...

MPP - I know. I seen too many of your stories like this.

OPS - Yes. I try and like her. And just when I think she's doing something on her own that is good, she retreats back to the world of the orange asshole.

B - You need to start boning up on all this. It will save you a lot of money in the long run.

I didn't think about a sympathy bounce. Maybe we shouldn't pick on him too much. But I do hope he is out of commission for a couple of weeks at least. And maybe no more debates. Wouldn't that be nice.

Mr. Shife said...

What a nightmare, Mike. Hope it all gets sorted out. I have one medicine that they don't run through insurance because it is cheaper out of pocket. It is a strange system.

Mike said...

MS - Strange system is an understatement.

dellgirl said...

This is soooo frustrating, I hope you get it all sorted out without too much trouble. This kind of stuff drives me totally insane. Good Luck, Mike.

Mike said...

DG - I think I'll need more than luck.

Cloudia said...

Thanks for the info, Mike

Mike said...

C - I hope your info is better. Not that I have it bad. Far from it. I'm just a middle class white person complaining about things I shouldn't complain about.