3 ms·

Around 2010 I went freelance and was shopping for medical insurance. I'd been on Blue Shield from a previous employer plan and liked them, so I compared their p

Around 2010 I went freelance and was shopping for medical insurance. I'd been on Blue Shield from a previous employer plan and liked them, so I compared their plans. I was taking one prescription medication that cost $195/month if you paid full retail price. The two plans I was comparing had a $100/month difference in premiums. They were pretty similar in most ways, but the more expensive plan had full coverage for this medication (minus a $20/month copay), and the cheaper plan did not cover it at all. This was a no-brainer, right? Obviously the more expensive plan would be the better deal. Some years later I happened to join Kaiser, and their pharmacy page listed the actual cost of the medication: $23/month without insurance, not $195. And if I bought a 100 day supply the total copay for the three month+ refill was $30. Out of curiosity I checked Blinkhealth and GoodRx, and yes, they each showed a total cost of about $23/month cash payment with no insurance.

endre 4y ago
what? how? how can they sell it for $195 then? pharmacy knows if you have insurance and then sells it to you for a more expensive pricetag?
- Stratoscope 4y ago
  $195 was the retail price for the name brand drug. Even though my doctor had prescribed the generic (which I've taken for many years now - in fact I don't think I've ever taken the name brand), the pharmacies were charging the name brand price for the generic unless you had insurance. One time when Blue Shield messed up on my premium payment and the pharmacy didn't think I had any coverage, I went ahead and paid the full $195 out of pocket to avoid delaying the refill. That was what got me curious about checking the actual cost of what I was buying. Here's how I feel about this: "Nice prescription you've got there. Be a shame if anything happened to it."
  - endre 4y ago
    > unless you had insurance nice. not nice. and I think the same could happen in Europe as well.

endre 4y ago

what? how? how can they sell it for $195 then? pharmacy knows if you have insurance and then sells it to you for a more expensive pricetag?

Stratoscope 4y ago
$195 was the retail price for the name brand drug. Even though my doctor had prescribed the generic (which I've taken for many years now - in fact I don't think I've ever taken the name brand), the pharmacies were charging the name brand price for the generic unless you had insurance. One time when Blue Shield messed up on my premium payment and the pharmacy didn't think I had any coverage, I went ahead and paid the full $195 out of pocket to avoid delaying the refill. That was what got me curious about checking the actual cost of what I was buying. Here's how I feel about this: "Nice prescription you've got there. Be a shame if anything happened to it."
- endre 4y ago
  > unless you had insurance nice. not nice. and I think the same could happen in Europe as well.