5 ms·
So basically, with a high deductible plan, I am getting screwed by my insurance company, because I do pay $300 for Advair out of pocket, instead of the negotiat
by bisRepetita 10y ago
So basically, with a high deductible plan, I am getting screwed by my insurance company, because I do pay $300 for Advair out of pocket, instead of the negotiated price.
- refurb 10y agoCorrect! You are typically responsible for the list price, not the net price the payer pays. So, you pay $300 for the drug (list price). The insurance company uses that $300 to pay the drug company, which in turn, rebates $150 back to the payer. Pure profit! If you are just responsible for the co-pay it works better. You pay $30, the payer pays $270 and the manufacturer rebates $150. Overall, the drug costs $150, $30 coming from you and $120 (net) coming from the payer.
- lintiness 10y agowhat you pay for advair should have little / nothing to do with your plan deductible. you should still get a negotiated, lower than retail price for drugs.
- alistairSH 10y agoI'm not sure that's true. In cases where I've had a deductible, I've always paid the lower negotiated price. The vendor (doctor or pharmacy) has always run the product through insurance first, then billed me whatever my insurer says is correct.
- refurb 10y agoIt's really up to the payer as to how much you are billed. I have heard of them passing along the negotiated discount, but it doesn't always happen.