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I had no idea the 30 day coverage of generic drugs cost me more with insurance.

So the other day I went to my pharmacy with a prescription for a 90 day supply of a generic drug. When I went to pick it up, the pharmacist said, insurance would only cover 30 days. So I said fine and paid $ 9.99 for the 30 day supply and left the pharmacy. But later on I got to thinking what would the drug cost if I wanted to just pay for it myself ? So I called the pharmacy and they said it would cost about $ 25.00 for the 90 days. So today I went back to the pharmacy and got the remaining 60 pills of the prescription for the sum total of $ 1.90. I guess on the phone they gave me the "cash" price, but I got the super secret good customer price of $11.89 ? I don't know but keeping the insurance company out of it saved me about $ 18.00. The pharmacist said they don't normally suggest keeping the insurance company out of the equation because it can lead to abuse. A patient can come in and fill a prescription for 90 days worth of a drug and then go get another prescription and fill it somewhere else for another 90 days. I never even thought about it but from now on if I have a generic prescription for some generic drug, I will ask what it costs without the insurance company involvement. Obviously I won't try it with insulin and the like, but heck if I can save some money on lipitor or zestril why not ?

Views: 146

Comment by Brian (bsc) on September 26, 2012 at 5:21pm

This sort of aberation occurs sometimes. Consider that Walmat has Metformin for $4/month and $10/90 days. If you pay through insurance you pay the co-pay, far more than actually paying the generic price. Far better to just pay out of pocket.

Comment by Sam Iam on September 26, 2012 at 7:26pm

I've noticed this too. Insurance companies need little excuse to take your money. Even being diabetic, I spend much less, without. It's very easy to rant endlessly about this.

Comment by Brian (bsc) on September 27, 2012 at 4:53am

On the other hand, I've observed the opposite effect where a simple test, such as vitamin D was billed to my insurance at like $8, but once when the messed up my insurance and billed me directly it was $232. That really ticked me off. What about those who have no insurance, they get up-charged. Sure, make the people who can't afford insurance or medical care pay nearly 30 times what the test costs. I'm sure this won't affect many of us, after all, according to Romney, half of Americans make enough money to actually pay taxes.

Comment by Tim on September 27, 2012 at 5:26am

This isn't really new... I remember when I went away to college and forked over "big money" for health insurance through the college. It turned out that if I didn't use insurance that insulin was about $12 a month OTC, or synthroid-generic was about about $5 a month for the generic. But to get insulin through insurance my co-pay was $20 through the college insurance, or $10 a month for synthroid generic.

(Remember this was like 30 years ago when all insulin was just $7-$12 a bottle and all insulin was available OTC without prescription/insurance.)

Really p***ed me off that working it through the insurance was way way way more expensive than me paying for it out of pocket.

Of course on other things e.g. lab tests, an A1C would be $80 out of pocket, or only $5 done by insurance company.

Comment by Scott Wilkins on September 27, 2012 at 9:58am

I get a couple at the "$4" price too. They don't even bother submitting to my normal insurance, just get it outright. I think they do apply a 3rd party insurance to it, but it's just semantics or tracking or something. I do get those at 90 days for $10, and don't believe my insurance would cover at 90 days either. It's a game of sorts. If you have a really really good pharmacist, they'd catch these before ringing up your perscription. But alas, few pharmacies are this good. They just work like robots "new perscription order, find patient in records, file with insurance on file" done. Oh well.


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