Skip to comments.The advantage of paying for medical care directly
Posted on 02/08/2020 12:32:30 PM PST by karpov
According to a PBS health report about a retiree on a Medicare Advantage plan, Z. Ming Ma was issued a prescription from her physician that cost $285 for a 90-day supply. A month later, the article says, Ma and his wife were about to leave on another trip, and Ma needed to stock up on her medication.
But her 90 days werent up, so Anthem wouldnt cover it. Ma asked the pharmacist how much it would cost if she got the prescription there and paid out of pocket, the article says.
The total cash price was about $40.
This is not uncommon. In fact, a study from USC demonstrated that nearly 25 percent of all prescriptions filled at the pharmacy cost the insurer less than what the patient paid in a copay. Yes, that means paying cash is more affordable than using your insurance card.
Over the past several decades in the United States, the health care industry has become increasingly dominated by third-party payers. An individuals health coverage, whether it is private, Medicare, or Medicaid, can significantly influence health care decision-making through deciding what it will, and will not, cover.
A health plan can determine which medical professional is seen, which prescription drugs are filled, and even whether a procedure can be done.
Because it increased the power of third-party payers, the Affordable Care Act was essentially a benefit to special interest groups such as insurance companies and other middlemen. The United States health care system hasnt always been dominated by third-parties but has become distorted from many years of government regulations.
The policy makers forgot about the patients and the medical professionals who provide the care.
The response from both groups has been entirely predictable and rational.
(Excerpt) Read more at thehill.com ...
If insurance is going to pay, people don’t care what the price is. There is no price-demand pressure on the market.
Try the GoodRX app on your phone
I lost my VERY good BC/BC policy, thanks to Obamacare more than quadrupling the premium
I can get 90 days of most of my meds for a fraction of what a 30 day refill costs without it
And it works with or without insurance. Just not if you’re on Medicare/Medicaid, as I understand it
It goes both ways on this. Sometimes it costs nothing much above the co-pay (if that), other times, orders of magnitude.
It doesn’t hurt to ask. It also doesn’t hurt to try to stock up on prescription meds, as about 90% of the Americans taking drugs on a regular basis are about to learn, as China’s exports begin to shut down.
How about YOUR CHOICE with YOUR MONEY. What a concept.
As far as insurance goes - any insurance - they ONLY way they can stay in business of course is to make money. Nothing wrong with that.
But to make money, the odds must be in their favor to make money and you to lose money. That is why they pay top dollars to Actuaries to figure all this stuff out. Otherwise, they'd go out of business. Insurance is a game where they're betting for you and you're betting against you.
Self Insurance is the way to go and is easy for most families to cover unexpected medical costs. All one needs to do is earmark savings each year for each member of your family.
I was in the office the other day and I overheard a person in the next office talking to an insurance company representative about this exact same thing.
But why should it cost more to co-pay than to just pay? That’s nuts.
Just put that app on my phone. Looks good for now !!
There is another program for those around Kroger and it’s affliates. I think it may be conjunction with GoodRX but not sure. You pay a yearly charge and many meds are free and or cheaper than Goodrx without it.
For example, some blood pressure medicines are free for a 90 day supply.
Just like there are advantages for paying for gas for your car directly.
That may be true on some drugs but I just picked up a $241 inhaler for $47 on my medicare advantage program. The previous month I paid cash and it was $241. Now that I met my deductible its $47.
No. Shut your mouth. Obama sponsored the AFFORDABLE care act. He is a god among men. /s
America, the land of the rent-seeking, parasitic middlemen.
These tapeworms are effectively printing their own money, donate part of the booty to the DNC, and the DNC promotes politicians who support the tapeworms.
It's an unconscionable racket.
I didnt think I could afford it, but then I realized if I cut our grocery bill from $600/mo to $100, got rid of those pesky pets that were costing us a fortune, and started living in our car, a lot of our problems would be solved.
We wouldnt have to deal with annoying traffic because wed be living in our employers parking lot; we wouldnt have to pay onerous utility bills, and showers are overrated anyway; wed lose weight on our restricted grocery budget; and wed have less stress in our lives so who needs pets anyway.
Obama was really looking out for Americans because he knew what was best for us.
I’ve known people who needed non-emergency operations and had no insurance, they got their operations for just a little over the price of most deductibles.
Just curious, what is the name?
Krogers is where most every med I get is the cheapest with GoodRX
I’ll sure check into it
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