That is seriously messed up. People will sell it as a good news story too which is true insanity.
The numbers are so mind boggling. This system is just ridiculous.
Yep - everyone just needs to have a gofundme, then have some national media report on you. Sustainable solid healthcare system at work.
Just got a bill for over $200 in the mail for covid test from the local clinic. Looking forward to the hours Iāll spend on the phone between clinic and insurance company fighting this bullshit.
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Went to the pharmacy to get a medication for my daughter - just pepcid in a colloid solution, or āsuspensionā. I think. Anyway, the local pharmacy is the one who āmakesā it, not the drug co.
Cost? $300. For pepcid. Without insurance.
Oh we have insurance. Itās $14.
So those who canāt afford insurance pay $300 and those who can pay under 20. Crackerjack system.
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Just had a prescription for 40mg delayed release capsules of doxycycline denied by insurance. Dr filed an appeal. Still denied. Would cost $520 out of pocket. But the good news is theyāll cover the 50mg version cause that makes sense.
I swear their entire business model is to make life as annoying as possible to the point where people just stop trying to get the care they need.
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Perfect depiction of the healthcare industry
Wow, doxy isnāt anything special, 100mg capsules are normally like $10 out of pocket. Is this some brand-name version of it because of the slow release?
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If you take this story as she doesnāt get surgery if thereās no fundraiser, itās a messed up story. Details are limited however, and the fact that sheās a child going to an elite Harvard affiliated institution makes it far less likely thatās the case. Children are generally insured (even in the worst of states), the article states she has insurance, and hospitals like BCH typically arenāt predatory assholes like that place in Indiana upthread.
If you take the story as people helping with the incidental costs of having an ill child such as the weeks off work, lodging, and more, then itās a far happier story. I think thatās the more likely one, and definitely the happier one, so thatās what Iāll take it as.
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I canāt think of a single reason why it has to be 40mg instead of 50mg. Hell my little reference I use doesnāt even show 40mg as an option. I would suggest that you ask your doctor if it has to be 40 instead of 50 because there might be a reason. If itās not critical switch to 50mg. The reason why your insurance is being weird is likely thereās only one manufacturer for the 40mg or your insurance company doesnāt carry a contract with someone that makes 40mg because itās such a rare dose.
I used to have a similar problem with fenofibrate. Various insurances I had over the years would cover only one of 150, 160 or 170 but not the others.
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The out of pocket cost for my meds per month is in the thousands. I pay ~$50.
Weāve used the 40mg delayed release in the past because Iāve tolerated it better given my severe Crohnās disease, and the GI side of my care team prefers I donāt use doxy at all. But weāre going to go with a 50mg version and see how it goes. Itās not a delayed release either but hopefully it wonāt bother me much.
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Hmmm weird well good luck!
Thanks. Itās really not a huge issue either way as Iāll either be fine or just stop taking it. I was more commenting just to vent how insurance denials are death by a thousand cuts. Everything from small stuff to medically necessary surgeries are denied and require an appeal. Iām sure you are familiar with it some from the Dr side of things. Itās just such a shitty system, but Iām grateful that Iām capable of navigating it at least. Really sucks for those who canāt.
I had sort of the reverse. Insurance refused to cover Pepcid AC because itās not prescription. So after multiple hours on the phone with my insurance, the gastro-clinic had them switch to something 20x as expensive which is covered.
So insurance is willing to cover $200/month or whatever instead of $7.99/month. And think of all the person-hours the gastro place, the pharmacy and the insurance co. spent arguing over my $7.99/month Pepcid AC.
And of course no one ever bothered to ask me if I donāt care about just paying it OOP, which I donāt. Such efficiency.
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I know this is super common but Iām looking at a bill from labcorp for a routine test my wife had and the charge is $909.00 (which is what someone without insurance would get billed), the insurance-negotiated fee isā¦ $50.07.
this country is fucking garbage
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The 7 cents is what throws me off. Iām sure that thereās some kind of software program that comes up with the negotiated price rather than actual haggling but what program comes up with 7 cents on top of the $50?
From what I understand, there is some actual haggling as well.
Basically labcorp will ask for X% over last year or whatever, and theyāll settle on Y% over and then they apply the percentage to get the new charge. So, itās not that surprising that you have weird numbers like that.
In a much surprise, very shock Doge twist, it turns out that this was not an accurate price quote, and my mom was billed nearly double that amount. After paying it in full and receiving a receipt for the payment, she then received another bill for the full amount and a mildly-threatening message about turning it over to collections. As was entirely predictable, the pumpkin spice smoothbrain she talked to on the phone blamed it on COMPUTERS.
Thatās not all though. The wheelchair scamstress rep at the hospital needed her credit card but told her she wouldnāt be charged. Because thatās what credit cards are forāto not charge people. Medicare paid for the device in full and now they are also charging her card for it. I bet itās COMPUTERS again! The itemized statement has every component of the device priced individually which I had to see to believe.
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