Don’t Pay More Than You Need To for Medications

Many people are unaware that the cost of their routine medications are sometimes actually less than the cost of the copayment on thier health insurance plan.  When filling prescriptions, it would behoove you to ask your pharmacist the cost of the Rx both with and without insurance.  Sometimes, it’s a better deal to use an app such as The Healthiest You, to compare drug prices in advance, to make sure that your insurance is getting you the best deal, before you buy! You may save as much as ten times the cost of an Rx, just by paying cash. This is especially true if your Rx is generic.  Bear in mind, if you choose to purchase your Rx outside of your insurance plan, the cost, of course will not apply to either your plan’s deductible or maximum out-of-pocket, but if you don’t anticipate meeting those thresholds, you may be better off just cash paying for your Rx.

Another way to save on routine medications is to use a Direct Primary Care physician.  DPCs often have wholesale pharmacies in-house and do not mark up the cost of routine medications.  You may even save enough on medications to cover the monthly cost of a DPC!

To save even more, check with your doc to find out if your pills can be split.  If so, have your doc prescribe a double dose of the medication, and use a pill splitter to get twice as much medication for your money.  Many generic prescriptions cost the same whether the dose is 10 mg or 20 mg, as an example.  Pill splitters can be obtained at a local pharmacy, and are a great way to help you make the most of your Rx dollars.

If you are taking an expensive brand name drug, and are having trouble affording the cost, check with the drug manufacturer of the Rx to find out if they have any patient assistance programs.  Sometimes, the manufacturer offers special deals for those who have low incomes or are without insurance.

 

Health Insurance and Pre-Existing Conditions

Guest Post by Dr. James Brook, D.O.

Many people seem to not understand what it means to require “insurance” companies to pay for people with pre-existing conditions. To do so would require companies to lose money. When companies lose money doing something, they have to stop doing that thing. Requiring “insurance” companies to pay for large immediate costs for a customer, in return for a much smaller premium, obviously requires them to lose money. I put the word insurance in quotes, because this scenario is not true insurance at all. The purpose of true insurance is to spread risk, so that an individual does not bear the full risk of devastating conditions. A small number of people develop very expensive conditions, and it is unknown beforehand who those people will be. Large numbers of people pool their risk by purchasing insurance. Then those who do incur large costs have those costs absorbed by the larger group of people, through their premiums. Premiums are based on the risk that a person has when entering the insurance pool, to the best of the ability of the insurers to determine the customer’s level of risk. Suppose somebody who had not previously been paying insurance premiums suddenly comes to find out he needs a knee replacement. Under the scenario of requiring “insurance” companies to pay for pre-existing conditions, the company would have to pay for this new customer’s knee replacement, while only being paid a premium that is a very small fraction of the cost of the surgery. The person who got his knee replaced could then stop paying premiums as soon as the surgery bill is paid. A premium has to exceed the predicted cost to the company. To avoid losing money, the company would have to charge an immediate premium that exceeds the cost of the surgery, since the probability of the cost is 100%.

What incentives then apply to patients? They are incented to not buy insurance at all, until costly conditions develop, and then apply for “insurance,” which the company is forced by government to provide. What incentive applies to the company? They are incented to stop doing business, because they are forced to lose money. Both of these things happened under Obamacare. People gamed the system, “insurance” companies lost enormous amounts of money, and they pulled out of the markets. All of this was entirely predictable, and indeed was predicted by many people. It is simple reality, based on incentives. It may feel good to require coverage of pre-existing conditions, but it is magical thinking to think that it can be done, while companies continue to stay in business. It may be heartless for companies to refuse to lose money on their customers, but would you go to work if you were forced to pay your employer to do it? If you are not willing to lose money by working, then you are being heartless to require it of others.

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Dr. James Brook is a Direct Primary Care physician in the state of Idaho, offering affordable primary care to patients willing to pay affordable, direct fees at the point of service.  Visit Dr. Brook’s website for information about his innovative health care model, and to learn more about his health care reform philosophy, clearly illustrated in his book, The High Price of Socialized Medicine.