As it has for many people, with the changing of the year came a change in healthcare insurance for the Space Lady and her husband. The changes were significant as, for the first time in 15 years, we switched from the insurance provided through her employer to the insurance provided through his. Good reasons, and had to be done, but little did she know how significant the changes would be across the board.
Confused much?
Off and on over the last couple of weeks, I’ve:
- compared coverages, chosen the plan that seems to make the most sense for us, enrolled in that plan, and set up a flexible spending account,
- discovered that the medical group we’ve generally used has withdrawn from the “network” of providers for this insurance (which means a whole lot of things that would take a whole other post to discuss),
- made multiple phone calls and dug through layer after layer of internet sites for employer benefits, primary insurance, prescription insurance, dental, vision, etc. etc.
I’ve collected id numbers and group numbers and plan numbers, and tried to navigate the maze of Tiers 0, 1, 2, and 3 drugs, transferred our prescriptions from CVS to Walgreens because it’s in the new insurance’s network (all the while feeling slightly guilty, as if I were sneaking around instead of just switching to a new pharmacy from the one we’ve used for years) . . . and discovered that some of the prescriptions covered by the old insurance aren’t covered by the new, and that both the copay and the cash price (for those not covered) differs by where you have the prescriptions filled ~ and differs significantly, sometimes.
Confused much? Yeah, me too. Which brings me to my point.
Yikes!
One of my prescriptions–omeprazole–was not covered, even though the prescription strength I require isn’t available over the counter (OTC). The cash price was substantial: around $160 for a month’s supply. Yikes! So, I bought some of the OTC version, doubled up on the dosage, and called it good.
It wasn’t even a week before I realized that it wasn’t working properly. The worst symptoms of my GERD were resurfacing, along with the panicky feeling I had for months before I found out what was making my chest ache like someone had put a stake through it every time I ate anything. Yikes! again.
The prescription omeprazole I had been taking was not only twice the strength of the OTC, but also in timed-release capsule form rather than tablets, and obviously the OTC tablets weren’t going to do the job, so I went online to see if I could find a reasonable replacement for the expensive prescription.
Something even better
I didn’t find that, but what I did find, thanks to the AARP website, was something even better: an article entitled “The Road to Prescription Savings should not be a “Secret” and a link (http://scpharmacist.net/) to the blog of Rick Hansen, the South Carolina pharmacist who wrote it . . . . 4 years ago.
Now, the article is, of course, targeted toward older people, but the advice he gives is useful regardless of your age: Things like asking your doctor to prescribe generics if possible and asking for samples of new medication, so you can see if it works for you before paying for a full prescription you might not then be able to use. I recommend the blog post to you for the advice alone.
Community Rx Assistance (CAPRX) Program (it’s FREE and EASY!)
Even better, however, is the list of resources to the left of the page on http://scpharmacist.net/, and it was there that I found the link to the Community Rx Assistance (CAPRX) Program, which provides you with a free, printable prescription discount card and a link to a site which will let you look up and price your prescriptions and tell you where you can buy them, and the approximate price ~ they even give you approximate distance and an online map link on each store listing! And I’m not talking about 2 or 3 stores that take this discount card. Every search I did for a particular prescription drug yielded 2 or 3 pages of listings even in the small city where I live in Indiana.
And the prescription that had a cash price of $160 at Walgreens? (despite the fact that I was paying less than $4 for it under the old prescription insurance) ~ with this discount card it cost $19.15 at the pharmacy in the Kroger store where I do most of my grocery shopping. I’m not a math whiz (by anyone’s stretch of the imagination!) but even I know that less that $20 beats more than $160.
Did I mention that it’s FREE?
The discount card is free; all you have to do is print it out. Then use the link on http://scpharmacist.net/ to look up your prescription drug and find out what it costs with the CAPRX card and where you can buy it. You can use it at any pharmacy that takes that card, for any prescription. (Before you go, though, I recommend that you call the pharmacy that you choose and verify that they do take the CAPRX discount card. That’s what I did, just because I’m the suspicious type, and I wanted to be sure I wouldn’t be wasting my time and gas money.)
Gone are the days . . .
Gone are the days of the neighborhood drugstore, with a pharmacist you knew by name, who had your best interests in mind. (In the small town where we lived when my kids were babies, it was Denny’s Pharmacy, and I knew Denny’s last name and after-hours phone number ~ and so did everyone else.)
We chose Walgreens when our new coverage made staying with CVS untenable, largely because it’s a pharmacy first (supposedly), whereas someplace like Kroger or Walmart isn’t. However, I was dismayed to find that even with the discount card, the prescription I paid $19.15 for at Kroger would still have cost around $50 at Walgreens and more than $118 at CVS.
Should vs Will
Should your “home” pharmacy tell you about this program when you need a prescription filled that your insurance doesn’t cover? Indubitably.
Will they? Apparently not.
So, thank goodness for people, like Rick Hansen and the people at AARP, who remember that it is people (actual, living human beings, not proliferate for-profit corporate entities like insurance companies and big pharma) that matter.
You go, Rick Hansen! Thanks for caring!
To Rick and all the rest of you ~ best wishes for a happy, healthy day ~ week ~ month ~ Year!
Cherie & ‘becca (aka: Shirley & the SpaceLady)