Cost of prescription

Discussion in 'Teacher Time Out' started by teacherkasey, Dec 20, 2007.

  1. teacherkasey

    teacherkasey Cohort

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    Okay... explain this one to me. I lost my health insurance when I was terminated in November. However, I am on a medication that I must take every day so I have to fulfill the prescription with or without the insurance.

    So I went to the pharmacy this afternoon to pick it up. When I had the insurance coverage, the insurance would cover $7 and I would pay $15. So that, although I have never been a math whiz, equals $22. Without insurance I had to pay $55. How did the cost go from $22 to $55:eek:? I know thats not a lot... but I haven't yet found a full time job with benefits and that little bit of extra cash could really have been used for other nexessities:(. It's like one slap in the face to another.

    Please help me understand...:unsure:
     
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  3. Danny'sNanny

    Danny'sNanny Connoisseur

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    My prescriptions are $70 or so each month with insurance. Without they'd be closer to $300!

    But none of mine would come even close to $22. I think a couple would be around $50-60 and one is $200ish (which I can't even imagine spending)

    That's pretty much why I'm not married yet- don't want to lose my parent's insurance!
     
  4. TeacherShelly

    TeacherShelly Aficionado

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    That is annoying, for sure. So it "cost" $22 before, and your co-pay was $15. Now that you have to pay full price it is $55? I'm curious who is getting the money.

    Sorry you have to pay out of pocket. Like you said, thank goodness it is a relatively tiny dollar amount compared to what some rx drugs go for.
     
  5. daysy_may

    daysy_may Groupie

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    Is it one that you could get rewritten to get the generic $4 at Wal-Mart?
     
  6. teacherkasey

    teacherkasey Cohort

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    Dec 21, 2007

    Good question. I will have to call my doctor and find out. Thanks:).
     
  7. DizneeTeachR

    DizneeTeachR Virtuoso

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    I was thinking the same thing?!?
     
  8. INteacher

    INteacher Aficionado

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    Here's a thought - most insurance companys operate on a preferred provider list. If you use the PPO you get a discount. I bet you were using the preferred place to fill your scripts so you were given the discount. Now that you don't have insurance, you must pay full price. Doesn't seem quite fair that without insurance you must pay more
     
  9. Emma35

    Emma35 Connoisseur

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    Shop around. Call different pharmacies. I do know that all pharmacies do NOT charge the same thing for drugs.
     
  10. sadundercover

    sadundercover Companion

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    I agree with INteacher. I think that is exactly the case. My husband just picked up one of his meds. It cost $7. On the med receipt it gives a retail price of $60. He would pay that if he had no insurance, but he pays the copay based on a discount of whatever amount from the original 60. It is the same when we go to the doctor. I think an office visit is like 60 (maybe more). We pay $10, but the insurance pays maybe about 40 or so, not the total of 60. Someone without insurance would pay the 60. There is a name for what the ins. company pays and I can't remember it right now. We get these printouts every time we have a doctor's visit-it shows all the charges laid out in a chart. I still cannot believe an MRI is like $3000 or $4000! And one night in the hospital last year without a bed (they left me in the hall and forgot me) cost almost $8,000.:eek: My dad had chest pains and did get a bed a couple of years ago and it cost $22,000 for one night and the next day! It makes me sick. I thank God everyday for our insurance.
     
  11. ABall

    ABall Fanatic

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    Target also does the generic for $4 and K-mart has 3 months for $15, some pharmacys have their own policies about price matching too.....
    but also some of them have discount cards.
     
  12. ABall

    ABall Fanatic

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    ask your doctor if he has samples until you get back on insurance.
     
  13. GardenDove

    GardenDove Habitué

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    I'm pretty sure out of pocket payers are currently gouged in healthcare. I think insurance companies get discounts. It's totally unjust and unfair. Your situation is an example of why our healthcare system needs an overhaul.
     
  14. mrachelle87

    mrachelle87 Fanatic

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    Also, my car insurance offers a discount program. Some state teacher unions also have a discount program. You don't have to have medical insurance for these. Also my electric co-op has a discount plan with some pharmacies. Check around.
     
  15. bonneb

    bonneb Fanatic

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    I have one that is anywhere from $2-$4 PER PILL! Check to find out if you can get generic, or even a different pill that does the same thing! Talk to the pharmacy and the doctor and check w/Wal Mart/Target. Good luck!
     
  16. love2teach

    love2teach Enthusiast

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    All generics are $4 at walmrart and target?? No matter what the insurance?!?!
     
  17. teacherintexas

    teacherintexas Maven

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    I was going to suggest the teacher organization the op belongs to also, but you beat me to it! ;)
     
  18. teacherintexas

    teacherintexas Maven

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  19. czacza

    czacza Multitudinous

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    When you have insurance there is an 'allowable' charge (for drs and prescriptions) the $22 that was your total before was the allowable charge and your pharmacy accepted your insurance. Had they not accepted your insurance you would have paid the price you are paying now.
     
  20. glenn

    glenn Rookie

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    People here in the United States are really overcharged for prescriptions. The pills are mass-produced and the ingredients they put into them cost very little. Having lived in both MI and AZ I have know people that have crossed the border and purchased their prescriptions in both Mexico and Canada for a fraction of the cost. I have one friend for a while was ordering from a Canadian mail in pharmacy and saving money doing that.
     
  21. Danny'sNanny

    Danny'sNanny Connoisseur

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    My mom has tried to get me to go into Mexico for my prescriptions, but it scares me!

    How do you know you're really getting what you think you're getting?

    I have friends who've done it for dental work and glasses, but not for meds. Maybe birth control...

    I'm just too nervous to do it...
     
  22. cutNglue

    cutNglue Magnifico

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    My doctors here are great. I ask for cheap meds to do the max benefits and ALL of my drugs right now are $7 each from more than one doctor!!!
     
  23. Jan 2, 2008

    As a pharmacist who has worked both in retail and insurance, I would like to offer my point of view. Groups such as unions and state and local governments that employ teachers have the ability to access contracted prescription rates through the major insurance companies. Without these contracts, pharmacies are free to charge their customers whatever the market will bear. As you would expect, pharmacies are usually reimbursed at a much lower rate through these contracts.

    If you find yourself underinsured, it is up to you as a consumer to educate yourself about the relative costs of all of your options. This includes comparing costs between pharmacies for the same drugs, and also comparing costs between different drugs that have the same or acceptably similar therapeutic effect. Some examples: Nexium v. Prilosec, Ambien CR v. generic Ambien, Soladyn v. generic tetracycline/doxycycline/minocycline. In these examples, the former option is about five times the cost the latter.

    Use the resources available to you. There are online price comparison sites, and $4 lists from Target and Walmart (which include only those products that cost Target and Walmart less than $4). Find web based information about new generics. And nothing beats having a good relationship with the neighborhood pharmacist who has the time to give advice.
     
  24. chicagoturtle

    chicagoturtle Fanatic

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    Did you ask the Pharmacist to make sure it wasn't an error?
    Also Montel Williams has some prescription assistance program- not sure how it works- but it's with one of the major drug companies.
     
  25. Master Pre-K

    Master Pre-K Virtuoso

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    ditto! or Sams Club, it would be well worth your $50 membership.

    Target is a little cheaper too. check your paper, and local food store. some places give $10-25 off transferring new prescriptions.

    My guess is, the new year caused a lot of things to go up. and if you can't get it from a local city/county clinic...what else can you do?

    write it off on your taxes, that's for sure.

    write to the drug company, some have a low cost/low income prescription benefit

    if you get it every month, you may be able to get it cheaper by bulk...6months supply. that much I know for sure. more you get, cheaper it is.

    start by asking for generic, then ask the company for help, and try Wal-Mart/Sams Club, and look into local clinics.

    I would get birth control pills from clinics all over town, whatever I could to keep my prescription. :unsure:

    oh yeah, and tell the doctor...they have TONS of samples...I am sure he/she wouldn't mind giving you a few packs, considering your circumstances. The drug companies give them plenty of samples!
     
  26. Master Pre-K

    Master Pre-K Virtuoso

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    hey turtle, look what I found!

    http://www.co.cook.il.us/prescription/
     
  27. chicagoturtle

    chicagoturtle Fanatic

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    hmm. I have pretty good coverage- I'm gonna have to start mailordering though- thats part of the lovely new contract - Gosh I wish it would have been voted down. I voted no as did 47% of the people who voted.
     
  28. Danny'sNanny

    Danny'sNanny Connoisseur

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    Oh...I hate mailordering prescriptions!

    I had to for a year (I lived in another state for school, so my insurance didn't work).

    My meds were late every single time! I'd call and they'd seriously say things like "Well, we've been behind becuase we've had some bad weather." or "We don't have you on our records."

    Ok, how did I get my pills the last 3 times, if I'm not on your records?"

    Aaarggghhh!
     
  29. chicagoturtle

    chicagoturtle Fanatic

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    Yeah- we're allowed to get 4 prescriptions filled and then anything they consider "regular use" they will make you go for a mailorder or charge you 20% more.
     
  30. Danny'sNanny

    Danny'sNanny Connoisseur

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    Ok- so are you only allowed 4 prescriptions total, or more than 4 means you have to use mailorder?

    I have 3 I need every month, another 3 I need regularly (my inhaler and my migraine meds), plus anything I need if I get sick (like antibiotics and pain meds from my surgeries...) so that's 10 different scripts in the last year...and I used to be on more but I cut down...
     
  31. Ima Teacher

    Ima Teacher Maven

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    It's the same way with doctor's services, too. For instance, my mom has a $2500 deductible on her insurance for any tests. She has to have bloodwork done every 3 months. If she paid for the bloodwork herself without going through insurance, it would cost her $98. Because of the "agreed price" with the insurers, they drop the price to $26.

    For her medications, she has one that she buys at Wal-Mart for $4 a month . . . and because it's just $4 (and her copay is $10), she doesn't use her insurance and buys her whole six month supply at one time for $24. She has to have the brand name for her other medication, and she gets it mail-order where they give her three months for a two month co-pay.

    My dog takes two insulin shots per day, and we called around to several pharmacies before getting the best price. It varied by as much as $12 from place to place.
     
  32. GlendaLL

    GlendaLL Aficionado

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    My husband and I are so fortunate to get our prescriptions for free. My husband is retired from the Air Force and one of his benefits is to get free medical prescriptions. We just have to take the prescriptions to the nearest Air Force Base pharmacy.

    Today I got a statement from Blue Cross. We have Blue Cross medical insurance and they get a bill from the Air Force pharmacy for the prescriptions that we get. I just got put on Vytorin (for my cholesterol) and the "bill" was for $300 for a three-month supply.

    Blue Cross covered their allowed charge of $230. We pay nothing - for any prescriptions.
     
  33. chicagoturtle

    chicagoturtle Fanatic

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    Say you take Zyrtec (I do) I can go to CVS or Walgreens etc 4 times and then I have to mail order. But I don't know if since I was getting it earlier I have to mailorder this month or not. I have my mail on hold- so lets hope it all gets delivered okay to me Saturday and then HOPEFULLY- THEY MAILED ME SOMETHING- otherwise- I'll call the union and ask what I'm supposed to do.
     
  34. Master Pre-K

    Master Pre-K Virtuoso

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    well, my daughter just got her first case of prescription sticker shock! she has humana hmo, and had to pay $40 for some ezcema cream! she is so upset. I tried to see if wal-mart or sams club had a better price. I told her, you need medicine, you have money...that is what money is for... get the stuff! she was so upset.. I offered to pay for it, but she said no.

    I know its hard...but what else can she do? She wanted me to make things better... I can't. All I could do was pay for it, but she didn't want that. Wanted to buy some lotion or over the counter cream instead. well, sams club pharmacist said cortaid is basically the same thing...but the medicine does has the anti-imflamatory stuff that she needs.

    I have to step back and let her handle this...

    sigh
     
  35. chicagoturtle

    chicagoturtle Fanatic

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    Wonder if that is "brand name" and there is a generic? My prescriptions are $10.00, $25.00 or $40.00 - The exzcema cream I have (triamcinaclone or something) is 10 bucks - but I get the generic.
     
  36. deedee

    deedee Connoisseur

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    My eye drops are $250.00 for a SMALL bottle ..thank god im still on my parents plan! I have been on 6 different eye drops in the past few months..not fun because even though I get them at a MUCH lower cost the money still adds up!
     
  37. Master Pre-K

    Master Pre-K Virtuoso

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    yep, it's called Elidel..no generic available! :(

    i remember trying to get some retin-A for my acne and something else... lotrisome for ringworm. they charged me two arms and a leg..and I ended up not finishing the prescriptions!! my insurance refused to give me pay saying it was for 'cosmetic' purposes!

    I don't see how a rash on your face is a cosmetic issue! It's a health issue and more importanly a self-esteem issue if you ask me! Nothing elective or cosmetic about that at all!
     
  38. Master Pre-K

    Master Pre-K Virtuoso

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    whoa...now that is something to cry about...

    sorry! :sorry:

    better take a class in something quick ... so you can keep their coverage until you reach 24!

    most colleges have student plans, and clinics...and it is much cheaper than individual plans! In fact, you can get a lot of services free! I use the campus clinic for my annual TB, test...and, I did my work physical their too!
     
  39. Danny'sNanny

    Danny'sNanny Connoisseur

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    The problem with student insurance plans through colleges is that they only work for the basic- I got sick and now I need X for a few days.

    When I was at an out-of-state school, I looked into the student plan so I'd be covered (my insurance only worked when I was home). But they only let you get 3 prescriptions a year. Umm...Ok, so I could use it for a month, and then I'd be out of luck? It wasn't worth it for me. :(
     
  40. deedee

    deedee Connoisseur

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    I used my schools for TB and physical ! No payment:2up:! Hopefully I will only need these prescriptions for a few more weeks. My eyes seem to all of a sudden hate contacts! I have been trying new solutions and contact brands but so far none have worked so ..back to the eye dr. oh well at least I can still see!

    As far as insurance plans I graduate in May09 and will turn 23 in May of 09 ...my parents plan drops me when I turn 23 whether I am still in school or not so I need to find a job quick haha :lol:
    But I dont even want to think about that yet ...:rolleyes:
     
  41. chicagoturtle

    chicagoturtle Fanatic

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    Tell her to ask her doctor for a differnet med that has generic.

    Also- Ringworm can be treated over the counter- same stuff that does athlete's foot and jock itch etc.
     

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