The New Way Insurers Are Shifting Costs To The Sick
http://talkingpointsmemo.com/news/insurers-pay-more-drug-conditionsInsurers have long tried to steer their members away from more expensive brand name drugs, labeling them as "non-preferred" and charging higher co-payments. But according to an editorial published Wednesday in the American Journal of Managed Care, several prominent health plans have taken it a step further, applying that same concept even to generic drugs.
The Affordable Care Act bans insurance companies from discriminating against patients with health problems, but that hasn't stopped them from seeking new and creative ways to shift costs to consumers. In the process, the plans effectively may be rendering a variety of ailments "non-preferred," according to the editorial.
"It is sometimes argued that patients should have 'skin in the game' to motivate them to become more prudent consumers," the editorial says. "One must ask, however, what sort of consumer behavior is encouraged when all generic medicines for particular diseases are 'non-preferred' and subject to higher co-pays."
Derp.
= new reply since forum marked as read
However my mail order experience is A+. Of course there's probably a good reason for this because my husband worked for a Union Company and our insurance has a drug policy included. I feel so very, very lucky at this point in time. When I decided to use the mail order I was unsure of how the experience would be, so I registered with their website to make sure there would be no mix ups.
To my surprise they have been very efficient and call us with reminders when we need refills in case we overlooked it. All I have to do is give them my birth date, zip code and my insurance ID # and they take it from there. If my script needs the doctor to approve a refill they call his office and set it up. On rare occasions I'm asked to call my doctor to solve a problem. And my medications are always shipped free.
I do think that Obama had to make some concessions with Big Pharma to get the ACA passed and we must be seeing that they're still getting their BIGGER share of the pie! This is unacceptable and I don't doubt they've found a way to keep padding their pockets!
I don't even think calling your Senator or Representative will be much help because of the massive obstruction movement to get rid of the program, small as it is.
My experience with belonging to a Union and being able to have a choice each year to stay with our current provider or change, has made me realize how fortunate we are. That's not to say I agree with how the health care system is run today because I know from statements I get how the money is spread around, and obviously it's skewed to benefit the rich even now.
It's so very important that Democrats vote, I fear the fight will get nastier if the Senate goes down. I have my issues with Obama and feel the ACA is only a very small step, but it's a start. So, so much more needs to be done and I worry all the time that Obama is being forced to sell out more and more. Plus, Obama's hands have been greased and concessions made that many of us find offensive.
THE GAME IS RIGGED... GREED ABOUNDS... "We The People Suffer!" I've been watching the PBS Series on The Roosevelt's and even though Franklin is at his core a politician with warts, at least he did see how the country suffered. I don't know how many are watching this, but it's an eye opener and certain facts about FDR show a different side of him. Still, he DID care.
We can only try to push back, but personally I think we're at a point in history where nothing is going to wake up enough people until the wheels come off. IMO that day is coming because even voting may only help a little. The districts are drawn to re-elect the same people and the glut of money going to the Oligarchs is being used for LEVERAGE in their favor!
$80.
that's right, double the "maximum" co-pay.
how? because they decided that 6 doses was enough (hah!) per month and if I need more, i can get a second box of 6 doses -- for a second co-pay.
other meds your doctor just specifies the count and strength and if the doctor says it's a 30-day supply, then that's that. in this case, zomig (along with other migraine-fighting triptans) are expensive, so my insurer finds it profitable to screw me over.
frankly, i think they're missing an opportunity here. why not just make the co-pay $40 for each individual dose? and why do it only for expensive meds? 
