Mail Order vs Local Pharmacy for Rx

[Sam]

I needed a prescription renewed for a 90-days supply and my local pharmacy called to tell me the price went up from $260 to $680. Did I want to have them fill it? I told them to hold off and I would get back with them.

 

I got with my doctor and he said we need to change the drug with another one that was equal and less expensive. So his nurse and I did some research and found another equal drug priced as follows for a 90-days supply:

Local Pharmacy    $133

Blue Cross Mail In $ 40

 

So I went with the Blue Cross mail in and set it up for future 90-day renewals.

 

I have no idea why the original dug's cost skyrocketed but am I glad to have Blue Cross and can use their prescription drug mail in program.

 

Just letting you all know in case you have a Rx mail in program with your group health insurance. Give it a try. You may be surprised at the cost and ease  using it.

 

But I do have a problem: how to spend the $620 savings I just enjoyed.  Green Top, here I come!

[Jig Man]

You bet there are so many price variations out there.  My insurance company does a good job of tracking meds.  If a cost skyrockets they notify me and recommend something else for my doctor and me to consider.  

[Oregon Native]

My wife watches this and insulin is horrible....among others dealing with cancer....

[TnRiver46]

On 7/26/2020 at 7:34 AM, Sam said:

I needed a prescription renewed for a 90-days supply and my local pharmacy called to tell me the price went up from $260 to $680. Did I want to have them fill it? I told them to hold off and I would get back with them.

 

I got with my doctor and he said we need to change the drug with another one that was equal and less expensive. So his nurse and I did some research and found another equal drug priced as follows for a 90-days supply:

Local Pharmacy    $133

Blue Cross Mail In $ 40

 

So I went with the Blue Cross mail in and set it up for future 90-day renewals.

 

I have no idea why the original dug's cost skyrocketed but am I glad to have Blue Cross and can use their prescription drug mail in program.

 

Just letting you all know in case you have a Rx mail in program with your group health insurance. Give it a try. You may be surprised at the cost and ease  using it.

 

But I do have a problem: how to spend the $620 savings I just enjoyed.  Green Top, here I come!

I know why the price skyrocketed: greed! The reason health insurance is so expensive is because drug companies are tripling prices all the time 

[J Francho]

My copay for insulin has gone up six fold what it was just four years ago.  There's no generic.

[Tennessee Boy]

Everyone should have the GoodRx app on their phone.  Put in the drug and your insurance company and it will find the lowest price in your area with a coupon provided on the app.  It can save you 90%.   I used to work with a guy that had to take prescription liquid potassium.  We're not talking about a billion dollar miracle drug,  we're talking about potassium.  His insurance changed and it went from $15 a month to $600.  He used the GoodRx app and was able to get it for $40 a month.    

[TnRiver46]

5 hours ago, J Francho said:

My copay for insulin has gone up six fold what it was just four years ago.  There's no generic.

That’s just ridiculous. A lady I work with had to take a second job when she found out she had diabetes. Now she never sleeps but at least she can buy insulin. Some drug companies ought to be tarred and feathered 

[J Francho]

15 hours ago, Tennessee Boy said:

Everyone should have the GoodRx app on their phone.

LMAO, GoodRx found the best "deal" for my insulin.  $480 a vial. 

[Spankey]

On 7/30/2020 at 8:07 AM, J Francho said:

LMAO, GoodRx found the best "deal" for my insulin.  $480 a vial. 

Is there a lot of different variations to insulin?

 

Do type 1 and type 2 use completely different medications? 

[J Francho]

Yes, and sometimes.

[FishTank]

I have tried both and no mater what, I feel like am a getting taken advantage of.

 

The weird thing is that some RX's are cheaper without my insurance so I always ask just in case.   Good example of this is a guy I work with was tested for Covid-19.  He was told it would be over $3000 at the emergency room if they used his insurance, $400 without and there was no difference in the test or the lab they used.  He did test positive and the treatment was way cheaper with insurance than without.  He came back to work after being off for about month and is now fine but he was lucky he got the right person at the hospital to handle his billing.   In the end he said none of it makes any sense. 

 

 

[Sam]

On 8/2/2020 at 6:57 PM, FishTank said:

I have tried both and no mater what, I feel like am a getting taken advantage of.

 

The weird thing is that some RX's are cheaper without my insurance so I always ask just in case.   Good example of this is a guy I work with was tested for Covid-19.  He was told it would be over $3000 at the emergency room if they used his insurance, $400 without and there was no difference in the test or the lab they used.  He did test positive and the treatment was way cheaper with insurance than without.  He came back to work after being off for about month and is now fine but he was lucky he got the right person at the hospital to handle his billing.   In the end he said none of it makes any sense. 

 

 

Fish, if you know the medical industry's financial structure and how they try to avoid taxes you would understand.

 

The insurance company will make the hospital or provider "discount" their normal rates by 45% to 70%. So a $3,000 hospital bill can be reduced to $900 and the hospital has to accept it. Does this mean the hospital can "charge off" the $2,100 on its income taxes as uncontrollable?

 

If the individual does file an insurance claim and that individual's insurance plan has either a "deductible" or "Co-Pay" then no matter what the medical facility or provider receives the individual is still responsible for his portion of the service charges. 

 

So you can see how complex the financial situation is with medicine these days.

 

Although the billing can get confusing we still have the best medical care in the world.

[J Francho]

2 hours ago, Sam said:

The insurance company will make the hospital or provider "discount" their normal rates by 45% to 70%. So a $3,000 hospital bill can be reduced to $900 and the hospital has to accept it. Does this mean the hospital can "charge off" the $2,100 on its income taxes as uncontrollable?

Conversely, a provider will bill insurance more for a service, knowing they will negotiate a lower price.  Bill $1000 for a $500 service, and get $750.  Who pays?  The patient.

[Way north bass guy]

6 hours ago, Sam said:

Although the billing can get confusing we still have the best medical care in the world.

After looking at these numbers you guys are putting out for meds and hospital visits, I respectably have to disagree with this statement  ??!

[RoLo]

 

No administration has yet been able to hold the feet of Big Pharmas to the fire.

Until such time, we will continue to grovel in the sands of lower prices,

in an industry founded on: 'Whatever the traffic will bear'.

 

Roger

 

[TnRiver46]

15 hours ago, RoLo said:

 

No administration has yet been able to hold the feet of Big Pharmas to the fire.

Until such time, we will continue to grovel in the sands of lower prices,

in an industry founded on: 'Whatever the traffic will bear'.

 

Roger

 

Methinks this is because the “administrations” are “elected” with funding they receive from big pharma 

 

[J Francho]

We've ventured far enough into verboten territory.