What You Don't Know About Your Health Insurance

Filed in Gather News Channel by on April 15, 2008 0 Comments

What You Don’t Know About Your  Health Insurance, Could Soon Be Costing You Thousands.

April 15, 2008 — Posted by Catherine Morgan

Even if you have health insurance, you may see your prescription drug costs rise higher than your monthly mortgage. Yes, you heard me right. You could be paying $20 a month for your prescription medicine today, and hundreds (or even thousands) tomorrow.

This is a story that has been developing for years (thanks to the Bush administration), but for some reason has gotten little to no attention from the media. I wonder if that could have anything to do with all the money the media collects from the pharmaceutical industry in advertising (over 33 billion just in 2004)? Conflict of interest? Even after an article in The New York Times became one of the most emailed stories yesterday, I was only able to find one (25 second) video clip from a major news outlet covering this story.

So, how will this affect you? Here is some of the information you aren’t hearing about until you get to the pharmacy…

This is from an article in The New York Times

Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.

With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drugâ€TMs actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.

The system means that the burden of expensive health care can now affect insured people, too.

Buying Prescription Drugs or Paying Your Mortgage?

While the majority of consumers may appreciate lower monthly insurance premiums and co-pays, this industry change has severely affected a limited portion of the population with potentially fatal health issues. For some, the payments structure change has increased prescription costs from $20 to “spend(ing) more for a drug than they pay for their mortgages.â€Â Some of the population impacted by this change is on a fixed or low income, which makes this jump in prices more challenging to handle.

Daily Kos: State of the Nation

In record numbers insurance companies are refusing to pay for a variety of expensive lifesaving medications.

This is scary, scary business, dear friends.

Co-Payments Go Way Up for Drugs With High Prices

Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.
. . .
This reality has hit a nerve. I’m not surprised. It’s frightening to read about an anonymous citizen who’s losing access to a drug that is quite literally keeping her alive. You know that it’s only a matter of time until someone in your own family faces the same insurance industry grim reaper in a business suit.

Patrick from Nuts & Boalts says it best…

Does anyone really think it is a coincidence that patients with conditions like MS, Hemophilia and Hepatitis C also tend to be the patients who *gasp* require more medical services in general? The new pricing scheme is not a way to “curb rising drug costs.” It is a way to discriminate against people with chronic disease, who are not fortunate enough to be in a position to self-advocate.

The immediate effect of the change will be that patients with unprofitable disease will either go bankrupt trying to pay, or stop taking the medication. The ultimate effect will be that patients with chronic AND unprofitable disease leave the health system (a euphemism for dying) more quickly, and cease to be a profit-suck.

Co-Pays Soar

In January, shortly after Ms. Steinwand renewed her insurance policy with Kaiser Permanente, she went to refill her prescription for Copaxone. She had been insured with Kaiser for 17 years through her husband, a federal employee, and had had no complaints about the coverage.

She had been taking Copaxone since multiple sclerosis was diagnosed in 2000, buying 30 daysâ€TM worth of the pills at a time. And even though the drug costs $1,900 a month, Kaiser required only a $20 co-payment.

Not this time. When Ms. Steinwand went to pick up her prescription at a pharmacy near her home in Silver Spring, Md., the pharmacist handed her a bill for $325.

There must be a mistake, Ms. Steinwand said. So the pharmacist checked with her supervisor. The new price was correct. Kaiserâ€TMs policy had changed. Now Kaiser was charging 25 percent of the cost of the drug up to a maximum of $325 per prescription. Her annual cost would be $3,900 and unless her insurance changed or the drug dropped in price, it would go on for the rest of her life.

“I charged it, then got into my car and burst into tears,â€Â Ms. Steinwand said.

From Fact-esque: Patients Pay Thousands

This was almost inevitable with the way the Bush prescription drug plan was written – and sold. He as much as told Big Pharma that they could start charging more and there would be no consequences. So they did.

So, now you know. Even having insurance does not protect you from the healthcare crisis in this country, and we have George Bush to thank for that.

Let me know what you think about this in comments. Could you afford to see the cost of your medications higher than your mortgage? What would you do?

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I am a born-again Christian,trying to serve my Saviour in anyway I can....... MOTTO::"" The hardest thing in life to learn,is which bridge to cross or which bridge to burn"""

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