But the problem is that medical costs are only as high as they are because of insurance. Hospitals started making up fake, artificially high prices because insurance companies wanted a discount for referring patients to their hospital.
I’ve heard many a tale of contacting the billing department and telling them you don’t have insurance and either they can get what money they actually need or none of it. They end up getting a much smaller bill.
I’m not in the US, but one of the issues I have with medical insurance is that, say you need medication, the doctor will provide you with a prescription, requiring a specific brand due to the efficacy compared to other brands. The insurance providers would reject claims for the prescribed brand, and suggest an inferior brand that doctors warned to avoid.
This happened to my older folks, and is baffling why insurances feel the need to override a doctor’s recommendations.
Not necessarily. I’m on a daily medication that has a generic but is available in both extended release and immediate release forms. The extended release provides a more consistent dosage and has historically prevented me from getting sick. The immediate release causes inconsistent spikes and I have a history of getting sick on it. Insurance refused to pay for the extended release type for about 2 years before it made it onto their “formulary.” In the meantime I was using GoodRx and paying $100/mo instead of my paid health insurance pharmacy plan to make sure I wouldn’t get sick. The person I spoke to at the pharmacy management wing of the insurance company literally told me “you can get an app on your phone which will tell you when to take the immediate release medication.”
But the problem is that medical costs are only as high as they are because of insurance. Hospitals started making up fake, artificially high prices because insurance companies wanted a discount for referring patients to their hospital.
I’ve heard many a tale of contacting the billing department and telling them you don’t have insurance and either they can get what money they actually need or none of it. They end up getting a much smaller bill.
I’m not in the US, but one of the issues I have with medical insurance is that, say you need medication, the doctor will provide you with a prescription, requiring a specific brand due to the efficacy compared to other brands. The insurance providers would reject claims for the prescribed brand, and suggest an inferior brand that doctors warned to avoid.
This happened to my older folks, and is baffling why insurances feel the need to override a doctor’s recommendations.
They were the same drug. The generic version is made after the original patent runs out and is an exact copy.
Not necessarily. I’m on a daily medication that has a generic but is available in both extended release and immediate release forms. The extended release provides a more consistent dosage and has historically prevented me from getting sick. The immediate release causes inconsistent spikes and I have a history of getting sick on it. Insurance refused to pay for the extended release type for about 2 years before it made it onto their “formulary.” In the meantime I was using GoodRx and paying $100/mo instead of my paid health insurance pharmacy plan to make sure I wouldn’t get sick. The person I spoke to at the pharmacy management wing of the insurance company literally told me “you can get an app on your phone which will tell you when to take the immediate release medication.”