Health Insurance - Shocking Changes

I did not even look into insurance during open season because I didn’t plan to change anything. I just took a look at the changes for this year, and I am in shock.

My labs were previously cost me nothing if done by Labcorp. Now I have a 15% coinsurance fee on labs. That means no more labs from the LLMD for me. My primary doc just ordered labs for me to check Vit d and immunoglobulins. I didn’t even know at the time I requested it. Have no idea what the bill will be.

Drug copays for basic drugs went from $10 to $15 for 30 day supply.

Copays and out of pocket caps for many things have nearly doubled.

My wife and I have insurance through her Federal government job, which is typically considered to have good insurance options, and don't get me wrong they are good, but, even those plans are more expensive this year. Insurance companies have cut benefits and increased premiums this year. For example, Bluecross Blueshield basic was long assoicated with having no lab fees. This year lab fees are 15% co-insurance. I did learn through research this year that doesn't mean 15% of whatever the retail price of the lab is. It means 15% of whatever the negotiated rate is between the insurance company and the lab company. It's tricky because you have no idea what that rate is unless you call the lab company or the insurance company.

I'm certainly no expert in the insurance marketplace, however, I'm not surprised healthcare costs have increased with the pandemic, growing aging population, increased incidence of chronic illness, and general inflation.

Still, after having to leave work and going through the marketplace for a short time the current plans we are able to pick from through my wife's job are like finding gold.

Post Edited (Lymie24) : 1/17/2023 9:10:16 AM (GMT-8)

“ I did not even look into insurance during open season because I didn’t plan to change anything.“

I’m curious - what does that mean?

WbF: In case you didn't see it, THIS thread discusses medication costs and mentions some potential options for saving money.

I'll summarize them here:

GoodRX https://www.goodrx.com
SingleCare https://www.singlecare.com
Visory Health https://www.visoryhealth.com
Amazon Pharmacy https://pharmacy.amazon.com
Mark Cuban's Cost Plus Drug Company https://costplusdrugs.com

I've been using GoodRX and SingleCare, as they've had the best pricing in my area for the few medications I've searched. At the time, I did not know about Visory Health, Amazon Pharmacy, or Cost Plus Drugs. A Google search will reveal other pharmacy discount cards, but the ones I've checked were always more expensive than GoodRX and SingleCare in my area for the medications I searched.

Mark Cuban's Cost Plus Drug Company seems like it's going to be one of the cheapest ones, based on a few medications that I searched. But, that's through the U.S. Mail, so one can't drive down to the pharmacy to get their medication right away. If one has a couple of days to wait, that might be a suitable option. It could also be good for those who take medications regularly and want something delivered every month on a regular schedule.

Girlie said...
“ I did not even look into insurance during open season because I didn’t plan to change anything.“

I’m curious - what does that mean?

They sometimes call it "open enrollment".

I think they got that from the "old school" term for choosing / registering for collage classes. Your picking thru your options.

As WBF mentioned, this is usually done in the fall for the next year.

Post Edited (astroman) : 1/17/2023 1:21:11 PM (GMT-8)

Thank you, Rainy! You're a perpetual fountain of knowledge and always a valuable asset to this forum!

The cost of everything, from health insurance to auto and home insurance, has gone crazy. So for those who are sick and not able to work, the impact is even greater.

In choosing a drug plan this year, I had to choose one that does not cover Bicillin, which is considered a tier 4 drug. Although I purchased some from India in powder form, I still struggle to get it to inject properly. But it comes out to about $5 a shot, compared to $300-$400 from pharmacy here.

https://www.visoryhealth.com/

running wild said...
I had to choose one that does not cover Bicillin, which is considered a tier 4 drug. Although I purchased some from India in powder form, I still struggle to get it to inject properly. But it comes out to about $5 a shot, compared to $300-$400 from pharmacy here.

astroman said...
That's incredible. wow. I am still leery of foreign meds myself though.

Thats way more savings than these digital coupons could save you,....and Mark Cubans Cost Plus Drug online US pharmacies prob doesn't have that yet.

I looked up Bicillin on GoodRX and SingleCare. The "cheapest" price was $1,800 and went to over $2,200. There were three options for Bicillin and I checked all three separately. Outrageous and should be criminal.

I’ve been told Pfizer has a lifetime monopoly on Bicillin, meaning no generic for it.

Seems a pharmacist told me, years ago, it was created in 1950 and came with a permanent claim to be made by Pfizer. I think laws have changed since then, but other medicines made back then seem to not have that status.

Not sure why.

“ Thats incredible. wow. I am still leery of foreign meds myself though. “

I thought the majority of our Pharma comes from India anyway - no?

Girlie said...
“ Thats incredible. wow. I am still leery of foreign meds myself though. “

I thought the majority of our Pharma comes from India anyway - no?

Yes, but they are tested, and can be subject to unscheduled testing at anytime by the US company per FDA requirements/orders. Not so if its an India brand name (insert third world country of choice here) sold directly to the overseas independent consumer.

------------------------------------------------------------------------

(Not pharmaceuticals, but......I have tested and inspected components and materials used in US manufacturing, purchased from third world countries. As a supply "vendor" or sub/manufacturer, they can and will make changes to suit their need$ without disclosing this - Trust? Its a gamble.

Post Edited (astroman) : 1/18/2023 2:55:16 PM (GMT-8)

for those that are super leery of anything that is not made in their home country.

whilst i would agree - buying bulk ingredients that may have avoided normal quality assurance controls via grey market sources, or start-ups trying to make a buck before legislation catches up with them is likely to expose one to increased risks.

buying common pharmaceuticals like antibiotics and prescription medications from reliable sources in India or China, Singapore etc made by large pharmaceutical companies there, is not in the same risk category.
from my experience of international business i can say with good confidence that Pfizer will have the same purity standard in place for human medicines in its manufacturing plants all over the world - and in fact, the ABX bought in your home country probably often originate from the same factories.

i live in the UK- the country where the industrial revolution started, and arguably one of the most developed countries in the world - and yet i have had better medical care when travelling in Asia than i have received at home.