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Reset: What is you Prescription Co Pay?

TPC

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First of the year I couldn't use the Walgreens drive up prescription window, had to go in with my new card and group & ID number and get that dialed in. Then $2 each prescription.

Waiting in line people ahead of me were paying, $35, $83 all kind'a prescription co-pays.

Kind'a blew me away. That's expensive.
Wife has Good RX and on prescriptions that aren't covered knocks up to 95% off. Some of the old Buzzards at the Elks use that service Mark Cuban runs and claim it saves them a ton of money.

What's your Co Pay?
 
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Bobby V

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My prescriptions are mailed to me. My insurance pays for almost everything I take. 4 pills. They did switch from Express Scripts to Optum RX for 2024.
 

TPC

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My Ex worked directly for the CEO of AMGEN.
They were developing one of the most serious and important cancer fighting drugs there is.
If you get cancer, you'll get it in your course of CHEMO. It saves lives.

They needed billions of dollars to bring it to market.
I saw first hand how expensive it is to develop these drugs.
Hold that thought.
 

Waterjunky

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Most of mine is $5 for generic and i think $15 for brand name.
 
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Meaney77

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My Ex worked directly for the CEO of AMGEN.
They were developing one of the most serious and important cancer fighting drugs there is.
If you get cancer, you'll get it in your course of CHEMO. It saves lives.

They needed billions of dollars to bring it to market.
I saw first hand how expensive it is to develop these drugs.
Hold that thought.
I can vouch, its not cheap.....
 

Done-it-again

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$5-10 but use "single care" like a "good rx" for another and its 50% cheaper than what my insurance offers.
 

Sleek-Jet

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Up until this year it was $10/$20 for generic or brand name.

But at renewal this all changed. I've been denied a medication recently and copay makes no sense any more, it's like I'm paying a percentage now? Paperwork from the insurance company is ambiguous at best and I don't have time to figure it out TBH.
 

Done-it-again

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Up until this year it was $10/$20 for generic or brand name.

But at renewal this all changed. I've been denied a medication recently and copay makes no sense any more, it's like I'm paying a percentage now? Paperwork from the insurance company is ambiguous at best and I don't have time to figure it out TBH.
I've been denied as well, if you have a DR prescription then look up "single care" and see if your pharmacy accepts it and what your cost will be... Its crazy how much cheaper for just saying the word "single care" at the pharmacy
 

monkeyswrench

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Too much, too many...but still able to get them, so that's good.
 
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2Driver

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Prescription drug pricing is most fucked up thing Ive ever seen

That will be $350 please.

Do you have insurance? Yes
That will be $95 then.

I have an app on my phone that says Its $28. ok $28.
 

LargeOrangeFont

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Prescription drug pricing is most fucked up thing Ive ever seen

That will be $350 please.

Do you have insurance? Yes
That will be $95 then.

I have an app on my phone that says Its $28. ok $28.

Its another problem that there is no money in fixing.
 
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rrrr

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My scrips are all in the $10-$15 range except for one, it's $99/month. Can't complain, the cash price is over $900.
 

Singleton

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10% generic, 20% named brand until I hit out of pocket max. Then 0.

Huge reason I don’t leave where I currently work. Companies can’t match the HC benefits I get today
 

PlumLoco

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$2200/mo for insurance and I only get 2 asthma inhalers at $20 each. They are over $100 w/ no insurance.
 
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Kachina26

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Prescription drug pricing is most fucked up thing Ive ever seen

That will be $350 please.

Do you have insurance? Yes
That will be $95 then.

I have an app on my phone that says Its $28. ok $28.
And then sometimes it’s “that will be $10 for your copay. Oh, you’re paying cash? That will be $2.25”.
 

dezrtracer

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Express scrips was nice but , my plan changed a couple years ago to CVS Caremark . Pretty good on the prices I pay $4.00 to $15.00 for my prescriptions .
 

BoatCop

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I'm on TRICARE For Life, the MEDICARE Supplement and prescription program for Retired Military. When I first got on it, in 2015, Prescription co-pay was $0 for generic, $5 for name Brand Formulary, and $15 for Specialty Name Brand. Since then it's gone up every year. For 2024, it's $13 for generic, $38 for Name Brand Formulary, and $76 for Specialty Name Brand.*

*90 day supply, mail-order from Express Scripts.

But wait! There's More!!!!!!

You MUST obtain maintenance drugs (Cholesterol, Heart, Diabetes, Thyroid, etc) through Express Scripts, or else they won't pay for it. AND, even if the medication costs less than the co-pay, you have to pay the full co-pay. (my thyroid meds cost them around $4 for a 90 day supply, but in order for me to get it, I have to pay the $13 co-pay.

Now, I could get them totally free, if I go through a MTF (Military Treatment Facility) (DOD, not VA). But I'd have to have them transfer the private practice prescription to the MTF, which means waiting for an appointment (retired is absolute last for priority) with a MTF Doctor to re-write the script, plus the nearest MTF to me is over 100 miles away.

At least my wife gets all hers at no cost, through the Indian Health Service. And as both of us are teasing age 70, there's probably 15 different scripts, between the two of us.
 
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DarkHorseRacing

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I’m a CA govt employee so I was told when I got the job I’d never be rich but the benefits would be pretty much what makes the job seem like it pays much more.

At the moment my copay for Rx is $10 no matter what it is. Been that way almost since I signed up.
 
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TPC

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I’m a CA govt employee so I was told when I got the job I’d never be rich but the benefits would be pretty much what makes the job seem like it pays much more.

At the moment my copay for Rx is $10 no matter what it is. Been that way almost since I signed up.
Funny you mention that because my CHP friends were paid peanuts but promised good bennies. Really low pay. I was offered $6.10 starting pay with the LAPD, CHP was $3.75 an hour.
Now they collect those bennies. When the good bennies are mentioned in the media, there are those that think because they have better bennies than them, they deserved to get fucked.

Past LA Mayor Riordian was one of the critics. AKA Hemroidian. He'd go on FOX's Varney and paint a picture like the State and local retirees were featherbedding. In my case with the DWP pension plan he'd be bitching about. Hemriordian never mentioned $600 was taken out of paychecks to cover these bennies.
 
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TonyFanelli

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$0....But....a recent 3 day stay in the hospital bill was $ 43,000. Insurance (@ $1750 a month) covered all but $2500...🫣🤔😶😵
 

TPC

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I have the wife on my plan. Her work dropped outside healthcare and prescriptions. Instead they want employees using in house doctors and pharmacy.
NFW are the nurses going to climb up on that table and spread on stirrups for a doctor they work with.
Pharmacy sure, but she uses my coverage here in town.

Wife wanted me to switch to Kaiser until she went to my doctor. My doctor looks like a 29 year old, brutally handsome Brad Pitt so after her first visit she said it's OK, no need to switch.
 

Angler

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I have the wife on my plan. Her work dropped outside healthcare and prescriptions. Instead they want employees using in house doctors and pharmacy.
NFW are the nurses going to climb up on that table and spread on stirrups for a doctor they work with.
Pharmacy sure, but she uses my coverage here in town.

Wife wanted me to switch to Kaiser until she went to my doctor. My doctor looks like a 29 year old, brutally handsome Brad Pitt so after her first visit she said it's OK, no need to switch.
One thing I love about Kaiser, you don't need to wait for referrals. Knee replacement surgery was under $400 with meds and PT.
 
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CarolynandBob

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Ours is pretty good. I think 10 max except for my Creon. It cost insurance co 7500 every 3 months with a 175 co pay to me, but the company has a co-pay help code that you give to the pharmacy which takes the co-pay down to $5 for 3 months.
 
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Romans9

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I will take the time to write out a post about my ”insurance” experience and put on display the absolute scam and racket that most of it has become.
 
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TPC

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From Kaiser, 0 to $11.85
Wifie loves Kaiser.
She says ya "only have to know how the system works for it to run smoothly for you." Know which buttons to push.

I kind'a look at it like I look at Electric cars. Good if you're mostly close to home.
Wife disagrees.
 

samsah33

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Ranges from $10 to $250, it's priced in 4 tiers with different prices for pickup vs delivery and in-network vs out-of-network, e.g. Tier 1 in-network + generic is $10 for pickup (typically 30 day supply) and $20 for delivery (typically 90 day supply)... o_O🤯o_O🤯

I'm also on an HSA since me and the fam are not big consumers of healthcare. The kicker on the HSA is that service providers will give better cash prices vs running thru insurance, which leaves me with a dilemma because cash doesn't count towards my annual OOP whereas the insurance price does... At the end of 2023, my daughter needed some PT and they offered us $150 per visit cash vs $300 thru the insurance. The $150 cash will not count towards my annual OOP but the $300 will. Since it was year end and I wasn't going to meet my annual OOP, I took the $150...
 
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Angler

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Wifie loves Kaiser.
She says ya "only have to know how the system works for it to run smoothly for you." Know which buttons to push.

I kind'a look at it like I look at Electric cars. Good if you're mostly close to home.
Wife disagrees.
I agree with your Wife.
 
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LuauLounge

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My first shock in the prescription market was a drug called Stivarga. It’s a cancer inhibitor. My copay was $2,800 for a 30 day supply. This was in 2015. It dropped to $700 on the refill. Got a call from my oncologist that said if I agreed to releasing my results that the cost would be zero. Sign me up…
 

lbhsbz

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I don't think I've ever gotten prescription drugs....the wife and kid have, but whatever I've been prescribed has been painkillers after surgery or antibiotics. I have antibiotics on hand, so I just take those instead. I prefer pain to painkillers because it tells me that if I do something that hurts...stop doing it...if swelling is causing the pain, I take an ibuprofin.

That said, the more you pay (or someone pays) for your insurance premiums, the less your meds will cost you.
 
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TPC

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One thing I love about Kaiser, you don't need to wait for referrals. Knee replacement surgery was under $400 with meds and PT.
Remember when you retire and are on Medicare, Kaiser has a supplemental to Medicare that is essential. It's really good for prescriptions and they will take your Medicare for the most tricky of treatments.
When I tap out that's the way the wife will roll.
For now,, it's Dr Brad Pitt.
 
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