Wednesday, February 10, 2010

A BOX of Pills

Since beginning to work for my company 18 years ago, I have been blessed to have fantastic health benefits.  I used to only pay $20 per paycheck for coverage.  Over the years, with the economy and health care price increases it has steady risen a litle at a time.  However, this year, it jumped about $23 a paycheck.  So, now, I pay $83 a paycheck for the two of us.  Okay, so I still don't think that's all that bad considering how much going to the doctor costs nowadays.  And, after seeing that the bill for my surgery in December would have been almost $10,000 without insurance, I'm pretty grateful for only having to pay $83 a paycheck for insurance.  But, along with the increased premiums, some of our benefits also decreased since we parted ways with "MS" in the last few years.  Since we have less employees to go on a contract with an insurance company, naturally the contract rates increased for both our company and our employees.  So, now we have to pay 15% of the bill along with increased co-pays and higher prescription rates.  These are some of the changes we're having to deal with:

Premiums:  $60 per paycheck increased to $83 per paycheck
Patient portion:  10% increased to 15%
  Regular visit - $25 increased to $30
  Specialist visit - $30 increased to $35
  Urgent Care - $25 to $50
  Emergency Room - $50 to $75
  Prescriptions - OUTRAGEOUS

In order to save money, the company chose a prescription plan that actually costs the employee less for using it, but makes it a pain in the everloving rump to get started on or ultra-costly to use a local pharmacy.

We now have to get our prescriptions through Caremark - a mail-order pharmacy service.  To get started on using this service, you have to get prescriptions from your doctor for 3 month-at-a-time refills for a whole year.  Then, you have to send them in.  Or, you can enter all of them into a website and then Caremark calls your doctor to confirm them.  Or, if you can get your doctor to just call them into Caremark, then that's the easiest and fastest.  I swear - it took 3 phone calls to Caremark to figure out the best way to get started, a visit to Melon Man's doctor to get the prescriptions, and an Excel spreadsheet to determine the best and most affordable options.  In the meantime, Melon Man ran out of pills waiting to see the doctor and for the new pills to arrive and thus was out of meds for about 8 to 10 days.  Not good.

However, the really nice benefit to this service is that we get 3 months of prescriptions for the price of two and all our generics are free if ordered through Caremark.  Still, it cost $300 for 3 months of meds for him through them.  There are actually two meds that it is cheaper to get them from the local pharmacy so we're going that route for those.  I figured out how much it would have been for the 3 months if we'd chosen to just keep getting them through the local pharmacy and it was $1,419!  OUCH!  I certainly hope we don't have to get a prescription for something there on short notice any time soon.  That would be expensive, I'm sure - except if there is a generic for it.  Then it's only $5 at the pharmacy.

Anyhow, Melon Man's meds arrived today - in a BOX.
Yep, there were so many of them that it was the only way to ship them (unlike mine which came in a little plastic shipping bag).  And the scariest thing about this whole situation is that the delivery person left it by our front door - and we didn't even know until 36 hours later!


Linda Lu said...

Kristin ~ Not for nothing but, get a load of this. I chose to go the High Deductible route for us because my husband has severe asthma and alergies. We pay $125.00 per paycheck and every January start with the new High Deductible of a whopping $2,400 out of pocket before the insurance kicks in and then 10% til we reach $3,200, after that the insurance will pay 100% of the cost til December 31st. We almost always have to put out the $2,400 in the first two months of the new year. My husband gets a shot of Xolair for his asthma that costs $600.00 every 4 weeks. Then all the inhalers and meds on top of that. And, Obomba wants Universal Healthcare! Mail Order is a pain in the rear, but once you get started, it's not so bad. Check into it online, we can click a button that will automatically re-order for us if we chose to do so. GOOD LUCK!

Jennifer said...

That is still pretty cheap compared to what we pay for everything. Good thing no druggies - or children found the box! Way to go delivery man!