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Insurance for Prescription Meds!

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April 10, 2023, 10:36 AM
flesheatingvirus
Insurance for Prescription Meds!
I've been picking up my insulin supply every 90 days from Walgreens for years. It was $35 for 6 vials. For some reason, this time they wanted $75. Nothing changed on my insurance.

I called my insurance and they claim I've been paying $75 every time, each time when they look it up in their system. Walgreens and my credit card history (and my memory) claim $35. They "have no explanation for this".

Walgreens can't explain it either. This shit is right up there with the last time I tried to shop around. "We can't tell you how much it is until you buy it." Mad

FUCK THE GODDAMN SCHEME THAT IS INSURANCE.


________________________________________

-- Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past me I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain. --
April 10, 2023, 10:59 AM
tsmccull
Could you hand them $35 cash and say “as has been done in the past, this cash identifies as $75 and is full payment for my insulin?”
April 10, 2023, 11:18 AM
hudr
It’s a racket, for sure.
Years ago, we picked up my daughter’s insulin at the children’s hospital. Paid cash…$8
Yes, $8 for about a 3 month supply.

Locally, my copay was $35.

Not suspicious at all….
April 10, 2023, 11:25 AM
h2oys
^^^ Does your insurance have a smart phone app/consumer-oriented website?

If yes, you should be able to price compare procedures ahead of time at different facilities. Perhaps you can do the same for prescriptions?
April 10, 2023, 11:50 AM
flesheatingvirus
quote:
Originally posted by h2oys:
^^^ Does your insurance have a smart phone app/consumer-oriented website?

If yes, you should be able to price compare procedures ahead of time at different facilities. Perhaps you can do the same for prescriptions?


No a comparison app, but I did send the prescription to a few places to see what differences I could come up with. The company is Express Scripts that handles the prescription portions of my insurance (BCBS of NM). The online cost through ES was always $75, but Walgreens quoted me at $35 years ago; that's why I was using them. Maybe I'll try Costco.


________________________________________

-- Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past me I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain. --
April 10, 2023, 01:49 PM
Genorogers
Not sure if they do insulin but try Northwest Pharmacy. I buy heart meds outside my drug insurance for 25% of what I can buy it through my local pharm. It's a Canadian company and they have saved me thousands. Exact same drugs that the USA plans and pharmacies distributes.
April 10, 2023, 02:31 PM
HRK
Shop around, Walgreens just changed it's price for you, someone audited and adjusted the rate, it's not your insurance, it's Walgreens.

You could talk to the head pharmacist at the store and see if that resolves it, they were accepting the amount your insurance paid plus your $35, now the system wants $75, perhaps after the first of the year when the insurance contract renewed they updated the system.
April 10, 2023, 04:32 PM
ZSMICHAEL
^^^^^^^^^^^^^
This. BTW leave Canadian pharmacies alone. Sleepy Joe did try and pass some caps on insulin. Check on that.
April 10, 2023, 05:19 PM
SR
Make sure to check programs like GoodRX. I had one med that was much lower on GoodRX than the Express Scripts or Walgreens price.

Walgreens takes GoodRX. Just have to give them the card.




Speak softly and carry a big stick loaded Sig
April 10, 2023, 05:32 PM
Chowser
Express Scripts will stop paying part of it at local pharmacies in order to push you towards their 3 month program. That’s what happens to me every time with my kids. The doctor is trying to find the right dose so two or three months it will be $10. Then they say switch to mail order to keep the cheaper price and Walgreens went up to $20.

Sometimes I just tell Walgreens to process it without insurance to see if it’s cheaper before I have Express Scripts run it.



Not minority enough!
April 10, 2023, 06:50 PM
berto
Was there a manufacturer coupon that expired? Lilly and Sanofi both had/have coupons. Sometimes they auto applied. Sometimes pharmacist had to do magic.
April 10, 2023, 07:22 PM
barndg00
I know we hate Amazon, but check out their pharmacy, better prices than local for me and I don't have to go to the pharmacy.
April 10, 2023, 08:23 PM
ZSMICHAEL
I believe there is a cap on insulin prices.
April 11, 2023, 11:50 PM
Rey HRH
quote:
Originally posted by ZSMICHAEL:
I believe there is a cap on insulin prices.


That's what I believe also. Either Biden or Trump signed it into law. But I guess it's only for people on Medicare.



"It did not really matter what we expected from life, but rather what life expected from us. We needed to stop asking about the meaning of life, and instead to think of ourselves as those who were being questioned by life – daily and hourly. Our answer must consist not in talk and meditation, but in right action and in right conduct. Life ultimately means taking the responsibility to find the right answer to its problems and to fulfill the tasks which it constantly sets for each individual." Viktor Frankl, Man's Search for Meaning, 1946.
April 12, 2023, 06:35 AM
V-Tail
I have found that for the meds that my wife and I use, Walgreen consistently is higher priced than other alternatives such as Publix pharmacy or Costco.

When a doctor prescribes something for me, I ask him / her to just give me the Rx, rather than sending it to a pharmacy. This allows me to look at GoodRx and find the best place to get the prescription filled. Most of the time it turns out to be Publix, with Costco a close second.



הרחפת שלי מלאה בצלופחים
April 12, 2023, 09:42 PM
flesheatingvirus
I'll definitely be shopping around. I hadn't thought about the possibility of a manufacturer-based coupon. I'll ask my doctor if I can have the prescription so I can try other places. Maybe she can give it to me for 60 units instead of a time-based prescription.

The pharmacist at Walgreens had no explanation for the price difference, either.


________________________________________

-- Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past me I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain. --
April 12, 2023, 09:51 PM
OKCGene
Have you tried GoodRx link

I use it frequently. Plug in the med and your area.

Good luck to you.
.
April 13, 2023, 07:08 AM
Blume9mm
Back when I was being 'released' from the hospital after having the big one... they gave me a goodRX coupon.. I've never been a fan of coupons... but this one allowed me to buy a 90 day prescription for 43 dollars otherwise it would have been just over 800. It is all a racket for sure... I've been recently paying about that ($43) for all three of my current 90 day scrips but the back in Dec. it went up to $53... then two weeks ago I went to get them and the cost was ....$0... beyond my little brains ability to figure out....


My Native American Name:
"Runs with Scissors"
April 14, 2023, 11:19 AM
selogic
My wife has been battling with Medicare and our Prescription insurance supplement . She is a Diabetic and tests her sugar several times a day . The Insurance will only pay for enough strips to test once a day as long as your sugar is " under control " . To get more than the 30 strips a month you have to jump through hoops and have the Doctor fill out forms and send them to Walgreens who will then submit them to Medicare , and on and on . It's a convoluted mess over something very simple .
April 14, 2023, 11:32 AM
ZSMICHAEL
sVery familiar with your problem. There is some hope with prior authorizations being limited. Of course it is just for certain things. Physicians spend hours per week getting these authorizations taken care of. It does nothing to help the patient.