People without insurance

[JenBKR]

I am only putting this in the doghouse because there have been a few other threads about insurance, or the lack thereof, and some have gotten a bit heated.

I get my medications through a mail order pharmacy through my health insurance. However, I am very low on my meds, and I know that I don't have enough to last until my shipment. So I asked the doctor to call me in a one month refill to a local pharmacy to hold me over. However, my insurance would not cover this because I had a shipment coming. So I had no choice but to buy a week of Prozac on my own. I paid around $26 for seven pills for the generic! That's approximately $3.72/pill. (I'd hate to see what the brand name costs!) With my insurance, I get a three month supply for $30. At first, I was really upset about the cost, but then I started thinking.....what do people without insurance do? How do they cope? I imagine they have to do without a lot of medications. My way of thinking has changed a bit through this. I am not angry anymore that I paid so much for 7 pills, but instead I am very thankful that I HAVE insurance to cover me the rest of the time. My heart and prayers go out to everyone without insurance.

Sorry for the pointless rant, just had that on my mind :)

[catnapper]

Not a pointless rant in any way.

I myself don't kow what I'd do without insurance. I may complain at how much it doesn't cover, but when I find out just what they DO cover I'm thankful.

My migraine pills were once denied, so I had to pay out of pocket $225. for SIX pills. I was desperate so I paid it. When you need a medication, whether its for pain, or for maintainence, you still NEED these meds.

My dad has Cerebral Paulsey (sp?) and is also prone to seizures. With insurance he pays well over $300 a month for the maint. meds to simply prevent sesizures. He's on barbituates (another sp?) to prevent seizures, these pills are monitored very closely by the insurance company... if he needs a refill for tuesday he can't refill the Rx until monday night. Once he dropped a pill down the sink and asked for a replacement -- you'd think he was lying and sold it to some kid to get high :rolleyes: Oh, my point? My point is what if dad didn't have insurance? Would he still be able to get his meds from a pharmacy? I can envision him standing on some dark street corner getting his meds from a drug dealer :eek:

[Marigold2]

Many Dr's give away free sample packs to people who cannot afford it. Please speak to your Dr. Were I worked we actually use to through meds away because they expired the reps brought so much in. My daughter gets free samples all the time from her Dr. she has gotten over a years supply already for free. Good luck.

[JenBKR]

Many Dr's give away free sample packs to people who cannot afford it. Please speak to your Dr. Were I worked we actually use to through meds away because they expired the reps brought so much in. My daughter gets free samples all the time from her Dr. she has gotten over a years supply already for free. Good luck.

My doctor didn't have any samples of Prozac at the time, they usually don't carry it. It's not a big deal for me, because I do have insurance, I am just feeling for those that don't :)

[Marigold2]

I feel for them as well. My meds cost me a pretty penny as well. There are free clinics but not everyone has access to a clinic close by. Dr's offices need to pass out the free samples to people who need them. Reps bring in suitcases full of the stuff, some drugs more then others. With a new drug they have lots of samples because they want the DR's to prescibe the stuff. It's all money driven as is everything in life except for love and oppsession.

[areias]

I do not have insurance either-I used to be on birth control when I had it-and well, I can't afford it now! I have no other meds that I need to take-but it gets hard when something happens and you know you should go to the doctor, but would rather not spend all the money..

[sparks19]

What pharmacy did you get these other pills from.... the ones that your insurance wouldn't cover?

I do not have insurance right now.... I am taking prenatal vitamins and 3 month supply cost $150 bucks at CVS. I was later speaking with a lady I know that works for an insurance company that deals with this type of stuff and she gave me some figures that would really shock you.

If I had gone to a mom and pop pharmacy or even Costco's pharmacy (which apparently you don't have to be a member to use) it would have cost us HALF or less than what we paid at CVS.

It was quite an interesting conversation. She said that most people don't look around for the best price because their insurance covers it.... but no one realizes how much the markup is in big name pharmacies like that. You could go to a family run place and other such places and get your meds for a fraction of the price you would pay at CVS or Rite Aid.

LOL not to mention I found out from the nurse later that taking two Flintstones Complete gives you the same thing my prenatal vitamins do. And it costs like 6 bucks for 150 lol.

[Marigold2]

Walmart is another place to get cheap refills.

[K9soul]

Insurance is responsible for driving the prices of things being so outrageous, because drug companies and hospitals can gouge a wealthy insurance company for more. A lot of hospitals have alternative charges (much more reasonable) for uninsured/cash paying patients. So while your bill may say a procedure was 5,000 and your insurance paid 4500 of that, a cash/uninsured patient may have gotten the same procedure for 1000 or less. Just basic examples. One could go on all day and night about the multiple aspects and facets of insurance. I think it can be good, but it also can be bad. The reason a lot of drugs and such became so expensive in the first place is because of insurance companies.

[Zippy]

Without insurance I wouldn't be able to get my meds.I have bi-polar and can't live without my meds.I am so thankful for my insurance.

[Donnaj4962]

I am fortunate because I have insurance, but Jen, I understand and sympathize with you on those who don't have it. I work with seniors, many of who are struggling to live at or below the poverty level. Many of them have to make decisions every month on whether to buy meds or food! How sad is that? And Medicare D ???? Oh, please, don't get me started. That could be a whole new thread!

Of course, there are places that one without insurance can go to get their meds. Planned Parenthood can help with birth control pills, and many communities haev social service organizations that specialize in helping low income and no insurance folks with their health care costs. We here in Fort Wayne have the Neighborhood Health Clinic, Matthew 25, and even some local churches that help with meds. Often, you just need to call your local 211, and you can get the information you need. :)

[sparks19]

Insurance is responsible for driving the prices of things being so outrageous, because drug companies and hospitals can gouge a wealthy insurance company for more. A lot of hospitals have alternative charges (much more reasonable) for uninsured/cash paying patients. So while your bill may say a procedure was 5,000 and your insurance paid 4500 of that, a cash/uninsured patient may have gotten the same procedure for 1000 or less. Just basic examples. One could go on all day and night about the multiple aspects and facets of insurance. I think it can be good, but it also can be bad. The reason a lot of drugs and such became so expensive in the first place is because of insurance companies.


That is very true.

When i went for my blood test... the "with insurance" rate was going to cost us over $500 bucks... but because we were paying cash it only cost us $140 for all the tests. One test alone would have cost $291 with insurance.... with cash payment it cost $60.

people are so shocked to hear how much our Dr is charging for the exams and delivery of my child.... they say it can't be true because with their insurance they had to pay 10's of thousands. it's amazing how cheap everything can be with the right Dr and without insurance. I mean really.... you are kinda paying the same amount with or without insurance... they just jack up the price for the insurance companies to pay.

[cassiesmom]

I'm a nurse and this is a rant I'd love to join.

A few thoughts
1) Tell the nurses at your doctor's office, or the doctor, that you need sample packs. When the pharmaceutical representative comes to the office that handles the brand you need, the office staff can get sample packs from the rep. Sometimes sample packs are made but the office just doesn't have that particular medication on hand. If they know in advance that they have a patient who needs a specific drug, they can stop that particular pharm rep and request samples.

2) There is the Partnership for Prescription Assistance (pparx.org) which is a program that links patients to pharmaceutical assistance programs of the different drug manufacturers. This is good if you don't know which one makes the drug you use. If you do (look on the prescription bottle or ask the pharmacist) you can look on their individual Web sites. The programs are out there but it falls to individual patients to hunt them down.

3) In Illinois our Governor is making his state of the State address today and he is going to propose insurance coverage for everyone in the state that's uninsured or under-insured. It will be interesting to see how it would be paid for and what the Illinois legislature thinks of the idea. We already have it for young children. At the same time the Cook County Board (that's Chicago) is trying to cut back services in the county health system to cut costs. Those two things (state and county) seem to me to be at cross purposes so we will have to watch and find out what happens.

[Freedom]

JenBKR, just wondering if you call your insurance co - even now, after the fact - and ask them what you are supposed to do when you get mixed up and don't re-order in time. There SHOULD be a way for you to get what you need!!!

I use a pharmacy, and the pharmacist has gotten to know Dad and I (and some of my pets) very well. If I mess up and need a refill and I am out of refills, he advances me 5, gets the doc to send in the new script, and then gives me the rest of the order.

CVS is known to be VERY high priced in this state. For YEARS they were the ONLY approved pharmacy for anyone on a Blue Cross plan. Talk about a monopoly! Three other pahrmacy chains had to join and file a law suit to get the legislature to make the needed changes! What a waste of funds, IMO.

I learned from when my Amber needed hypothyroid meds years ago to call around for the non - insurance covered meds. It seemed that every month I was getting it refilled at a different pharmacy. And they are all cooperative in handling the paper transfer themselves and leaving me out of it. So every time I need his meds, I called 3 or 4 places for the price, called back the order to which ever was the lowest, told them where the script was currently, and they took care of the transfer. Next day I would pick up his meds. And wait another month. My VET got mad that I wasn't getting the meds from him, and started charging $5 for a written prescription that left the office unfilled!!!!

As I am home caring for Dad and not working, I have to buy my insurance direct. There is only one company in the state that offers direct coverage - Blue Cross. For just me, one person, not a family plan, I am paying over $600 per month!

[Marigold2]

Hi Cassiesmom,

Excellent post.

[IRescue452]

I usually go without. After a lifetime, you get used to it. There's a million health issues I need taken care of. But its not going to happen. The one time I've been to the doctor in the past 4 years was when I ripped the tendons in my ankle. After 3 days of using our old crutches my grandma finally decided to pay for my visit out of pocket. It was only 400, but I'd never have gone otherwise.

[columbine]

In Massachusetts people will sometimes defer food expense by using a food pantry, then using the grocery budget to pay for their medicine. That's getting tricky, though, since so many people have caught on and the food pantries are stretched a bit thin. (Hmm, maybe it's time to whip out the ol' plastic and visit http://gbfb.org/ - things are going OK right now...)

Another thing you can do is ask a friend to fill your car up for you, in exchange for a return of the favor when you're doing well and they're not, and use the gas money for medicine.

There are also lots of places you can buy medicine online to get around the "she's American, she must be rich" surcharge. I used pillstrust.com when I hurt my back, and had my Flexeril before the covered supply ran out.

Love, Columbine

[Twisterdog]

We pay $270 per month for my step-son's medication ... AFTER our insurance pays some of it. It's crazy.

My son and I didn't have health insurance for ten years ... thank goodness we are both very healthy and nothing bad happened. It's such a frightening risk to take ... but sometimes there is nothing that can be done about it. I am self-employed and getting insurance for us was no where near my price range.

My parents are on dozens of prescription medications, as I'm sure most elderly people are. If it weren't for my dad's former employer's good retirement plan which pays for prescriptions, they would be dead, I'm sure.

[jenluckenbach]

I am withot health insurance. :( And I have 3 prescriptions. #1 I have always been able to get samples of from the DR. #2 is inexpensive, so when samples are not available I can just get at a pharmacy. #3 I receive through a patient assistance plan.
For me it is the Dr. VISITS that kill me monetarily. :(

[wombat2u2004]

I am withot health insurance. :( And I have 3 prescriptions. #1 I have always been able to get samples of from the DR. #2 is inexpensive, so when samples are not available I can just get at a pharmacy. #3 I receive through a patient assistance plan.
For me it is the Dr. VISITS that kill me monetarily. :(

This is all shocking to us poor Aussies......it shouldn't be that way for people.
Here it costs $35.00 to visit a doctor........and you claim back about $25.00
Wombat

[moosmom]

Partnership for Prescription Assistance is a great program for people who do not have insurance. That's how I got my meds before I qualified for Title 19. I highly recommend it to anyone!!

[king2005]

I do without any meds... My insurance is coming, but I needed it a loooooooong time ago...

[Sirrahsim]

This whole insurance thing is just crazy! When I lived overseas I got all of my medical care on base so I had no idea what civilian clinics charged! Now that I am in the states I am seeing a civilian OB and am SHOCKED at the amounts they are trying to charge my "insurance company". With one particular bill, the clinic billed them over $700 for some blood tests. I was even more surprised when my company payed them less than $200 of that and "disallowed" the rest. My doc isn't allowed to charge me a penny over what Tricare gives them but is perfectly fine with that. It makes me wonder how much the tests actually cost the clinic to perform if they don't mind a $500 mark off?!?!

[sparks19]

This whole insurance thing is just crazy! When I lived overseas I got all of my medical care on base so I had no idea what civilian clinics charged! Now that I am in the states I am seeing a civilian OB and am SHOCKED at the amounts they are trying to charge my "insurance company". With one particular bill, the clinic billed them over $700 for some blood tests. I was even more surprised when my company payed them less than $200 of that and "disallowed" the rest. My doc isn't allowed to charge me a penny over what Tricare gives them but is perfectly fine with that. It makes me wonder how much the tests actually cost the clinic to perform if they don't mind a $500 mark off?!?!


It would be interesting to see how much the tests would have cost if you were paying cash for them instead of through insurance.

I had to have 6 blood tests after one of my OBGYN appts. They had a price book and they had price for insurance and price for cash. It was going to cost over $500 if we had insurance.... but we were paying cash.... it cost us $140. What a difference.

[lizbud]

My parents are on dozens of prescription medications, as I'm sure most elderly people are. If it weren't for my dad's former employer's good retirement plan which pays for prescriptions, they would be dead, I'm sure.


A retirement plan like that is almost impossible to find anymore.

[wombat2u2004]

It would be interesting to see how much the tests would have cost if you were paying cash for them instead of through insurance.

I had to have 6 blood tests after one of my OBGYN appts. They had a price book and they had price for insurance and price for cash. It was going to cost over $500 if we had insurance.... but we were paying cash.... it cost us $140. What a difference.

Oh yeah....everybody loves insurance companies....lol.
I think the doctors do that here to.
But everyone I know who deals with insurance companies always charge them a higher price. And so do I.....if I do building work or consultancy reports for them, the price is DOUBLE what I would charge a householder.
And I think the insurance companies are very aware of that....after all....by their very own admittance (I know many underwriters).....they charge out their premiums to make HUGE profits.

[sparks19]

Oh yeah....everybody loves insurance companies....lol.
I think the doctors do that here to.
But everyone I know who deals with insurance companies always charge them a higher price. And so do I.....if I do building work or consultancy reports for them, the price is DOUBLE what I would charge a householder.
And I think the insurance companies are very aware of that....after all....by their very own admittance (I know many underwriters).....they charge out their premiums to make HUGE profits.


LOL Oh Iknow they are aware of it... sneaky buggers. But I have to be honest.... I had no idea until I had this series of bloodtests and saw what the difference in price was.

[petslover]

I don't have any insurance. I don't take my medicines like I should because I can't afford them and I don't go to the doctor very much unless I am very sick.

It sucks. I can't wait till I get out of school and get a full-time job with benefits..

It is very hard living without insurance.

[columbine]

The last time I went for a routine physical, my NP saw me at the front desk paying for it with a blank check my mother had sent me, looked at the bill, and crossed out a couple of "errors." :) My doctor's a total nothing, a harried family practitioner who doesn't find anybody but mothers and young children interesting and doesn't know me from Eve - but I stay with her because I love my NP! When I went to have what I thought might be a deer tick bite checked, he asked if I knew what a deer tick looked like, and when I said no, he showed me one scotch taped to a sheet of paper, and explained that Lyme disease is really pretty rare, and that my lesion looked nothing like a tick bite anyway.

Love, Colujmbine