• pleasejustdie@lemmy.world
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    17 days ago

    I’m not surprised… my work has UHC, and every year they cancel our current plan and force work to get a new one. Then every year around april they deny me for my annual doctor’s visit because they have in their system that I have a different primary insurance. And every year I have to call them and be like “who do you show as my 2nd insurance?” and they are always like “uh… no one… but we have marked you have one.” and every year I have to tell them, no, we don’t have 2nd insurance, just you, and then call the doctor’s office back and let them know, then wait a month for the doctor’s office to confirm they received payment and I’m no longer on the hook for the bill. Last year I had to do it twice, once for my medical and once for my daughter’s dental plan. They also aren’t even economic… they denied one of my medications, because they only cover the name brand that has a higher co-pay for me instead of the generic. They aren’t even saving money on it unless they are getting a giant kickback from the manufacturer. The without insurance price of the generic to me would have been like $50, but the without insurance for the name brand they want me to take is over $1500. And instead of me paying the $20 copay for the T2 medication and them paying $30, I pay $30 for the T3 medication and they pay $1470. So if they aren’t getting some massive kickbacks from the name brand, they are way worse off in this arrangement and it took me several hours on the phone, and multiple escalations, just to get someone who could tell me why I was denied coverage for my prescribed medication in the first place… Then I had to play phone tag with my doctor’s office to explain to them the issue and get them to change the prescription since they used the word “generic” in the RX and the Walgreens couldn’t fulfill a non-generic with that RX… If I had a choice, work would switch to a different company the next time they cancel our plan on us, but I’m a mushroom at work. (Kept in the dark and fed bullshit).

    • derpgon
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      17 days ago

      Oh boy, if it really is 50 vs 1500, then someone is obviously getting a ton of money in kickback.

      • pleasejustdie@lemmy.world
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        17 days ago

        I just double checked, currently the generic for my medication I used to take before UHC, can be gotten for just under $40 from CVS or Target, its $150 from walgreens for some reason (Either way, same copay to me regardless of whether its $40 or $150), while the name brand specific med shows $750 on their website, while goodRX shows I can get it from Walgreens or CVS for $650 for 30 day supply, but I have to take a double dose, so its yeah, between $1300 (GoodRX price) and $1500 (MSRP) per 30 day supply for me if I had to pay out of pocket for it.

        • jumjummy@lemmy.world
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          17 days ago

          May not help, but if you haven’t checked out Cost Plus Drugs, it may be worth a look. I can get a 90 day supply of my prescription for less than my one month insurance rate at my local pharmacy.

          Not a sales pitch for them, but I love the complete transparency in their pricing.

          Only downside is that the order to shipping process can take a bit, so for a regular medication, you need to somewhat plan ahead with your supply.