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People with GOOD insurance can't afford medicine!

So I have an ear infection and go to the doctor yesterday afternoon. I get a prescription for antibiotic ear drops. Go to the drugstore and they say it's $159.00. I say I have insurance and it should only cost me $10.00 co-pay if it's generic or $20.00 co-pay if it's name brand. They explain this medicine isn't covered by my insurance and there is no equivalent generic. So I either pay the full $159.00 or do without. I do not have the $159.00 to pay for the medicine because I pay $265.00 every 2 weeks to pay for insurance that does not cover the medicine I need. I realize this is not Obama's fault, but this is a situation a lot more of us working, insured people are going to face a lot more often if UHC passes and is implemented. In the meantime, what do I do for the miserable ear ache that I still have?

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pagan_mama

Asked by pagan_mama at 11:04 AM on Jul. 9, 2009 in Politics & Current Events

Level 7 (199 Credits)
Answers (26)
  • While I disagree with your statement about how the UHC will negatively affect us, I do agree that it is ridiculous the amount of money, right now, that we pay for insurance and the fact that many things are not covered under it.

    I pay $800/month for insurance for my family. Including co-pays, percentages, etc. we still pay a fortune for our medical coverage.

    My hope is that the health care reform will make it so that insurance companies are going to be forced to become more competitive - both in rates and in benefits.
    MommyRust

    Answer by MommyRust at 11:08 AM on Jul. 9, 2009

  • I would go back to the doc and ask for a different scrip that is covered by the insurance.
    riotgrrl

    Answer by riotgrrl at 11:08 AM on Jul. 9, 2009

  • get a different scrip
    we have good insurence nad we can afford meds
    Anonymous

    Answer by Anonymous at 11:11 AM on Jul. 9, 2009

  • it's not going to competep with the government? Nope private insurance will just likely go bye bye.I do noteven have to wonder IF the government will screw up healthcare it's WHEN.
    Anonymous

    Answer by Anonymous at 11:11 AM on Jul. 9, 2009

  • I used to work at a pharmacy and saw this problem all the time. Unfortunately, doctors do not know what is and isn't covered by your insurance. Sometimes they do with certain popular meds but most of the time they don't. Call the office, explain what's going on and see if they can call in something else, hopefully you can avoid having to go back to the doctor.
    tnm786

    Answer by tnm786 at 11:11 AM on Jul. 9, 2009

  • Do you have a meijer around you? I would try and go to their pharmacy. I wouldn't go to an actual drug store. I have found that their prices are outrageous compared to walmart or meijer. If they are still expensive there- just call your doctors office and tell them you can't afford the medicine your doctor prescribed and ask for them to give you something different. Don't go in who has the time to do that plus another copay! just call. You were just there so they shouldn't have a problem with it, at least our doctors office wouldn't.
    amy31308

    Answer by amy31308 at 11:12 AM on Jul. 9, 2009

  • To be honest, some of it was your doctor's fault. Insurance companies control most of what doctors can do. There is a list of drugs that your insurance will cover, if the drug isn't on the list the doc shouldn't prescribe it. I know that's not right, but that's the way it is right now and yes it will be worse under UHC. My docs have EMR in their offices so they bring their laptops in the room with them. Before they prescribe something they ask what my ins is and then they look up the drug list for that company and make sure they can prescribe they drug they want me to have. They will tell me when it's not going to be covered and how much it will likely cost me. It's a pain, and something definitely has to change. UHC is not the answer though.


    As far as the earache, call you doc & see if you can get something else.

    anime_mom619

    Answer by anime_mom619 at 11:13 AM on Jul. 9, 2009

  • Our doctor prescribe something for the eyes for my son. Don't laugh but the pharmacist said that the prescription was the equivalent for Visine.

    Call your insurance for the list of products covered.
    Anonymous

    Answer by Anonymous at 11:15 AM on Jul. 9, 2009

  • but this is a situation a lot more of us working, insured people are going to face a lot more often if UHC passes and is implemented


    First, thisstatement is not true, in other countries with UHC, most medications are free or close to it.


    Second, UHC is OFF the table. A public option is NOT UHC


    Third, your situation is the EXACT reason the system needs to be reformed TODAY!

    sweet-a-kins

    Answer by sweet-a-kins at 11:20 AM on Jul. 9, 2009

  • Before we lost our coverage with dh's employer, we were in the same boat. We had to play the call the doc get another scrip game...until we found one that would work and was covered by our co-pay. I thought it was a joke at the time. Now that our coverage is gone...I wish we had something, anything. We make too much to qualify, and not enough to be ok if something major were to happen. I must confess tho... I still feel "safer" without UHC!!

    I had to go to the ER over the weekend. I have been stressing about our bill. Making it difficult for me to get back to 100%. We are fairly healthy people...it's all about prevention. What happened to me was (hopfeully) a one time fluke that would not go away on it's own. Gotta love it!

    Sorry about your ear...I know they can be painful. Get another scrip.
    Loryl

    Answer by Loryl at 11:26 AM on Jul. 9, 2009

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