RANT: Rising Healthcare Costs

[Winter Storm]

So I got my new Aetna card the other week and noticed that my co-pay has risen from $15 to $20. It will now cost my $20 for any doctor's visit. Fine, I got over it quick. What's $5 right?

Well, I go to fill one of my Rx's today and instead of it being $40, it is now $60. :mad: I then decide to look up my birth control price online so there are no surprises when I have to refill. It went from $70 to $100. :mad: :mad:

What gets me is these costs just went up a few years ago. At this rate there might come a time when I can't afford to go to the doctor's or fill an RX even with insurance. Hell I may not even be able to afford birth control one day.

Fuck you Aetna! I fucking hate you!!!!

[pisces2473]

Aren't they supposed to tell you if copays and stuff are rising? Ugh, sorry Winter, that sucks.

[dengeist]

So I got my new Aetna card the other week and noticed that my co-pay has risen from $15 to $20. It will now cost my $20 for any doctor's visit. Fine, I got over it quick. What's $5 right?

Well, I go to fill one of my Rx's today and instead of it being $40, it is now $60. :mad: I then decide to look up my birth control price online so there are no surprises when I have to refill. It went from $70 to $100. :mad: :mad:

What gets me is these costs just went up a few years ago. At this rate there might come a time when I can't afford to go to the doctor's or fill an RX even with insurance. Hell I may not even be able to afford birth control one day.

Fuck you Aetna! I fucking hate you!!!!

Aetna is the worst. My grandmother complains about them all the time.

I just went to a rally about healthcare and benefits a few weeks ago.

[wordsmith]

At this rate there might come a time when I can't afford to go to the doctor's
Check
or fill an RX even with insurance.
Check
Hell I may not even be able to afford birth control one day.
And check. Already there. Sucks.

[arrow]

So I got my new Aetna card the other week and noticed that my co-pay has risen from $15 to $20. It will now cost my $20 for any doctor's visit. Fine, I got over it quick. What's $5 right?

Well, I go to fill one of my Rx's today and instead of it being $40, it is now $60. :mad: I then decide to look up my birth control price online so there are no surprises when I have to refill. It went from $70 to $100. :mad: :mad:

What gets me is these costs just went up a few years ago. At this rate there might come a time when I can't afford to go to the doctor's or fill an RX even with insurance. Hell I may not even be able to afford birth control one day.

Fuck you Aetna! I fucking hate you!!!!


Are you getting the generics? They are much, much cheaper. Also, Planned Parenthood offers affordable pills, if that's what you take.

And yeah, the healthcare system is f**d.

[wordsmith]

Are you getting the generics? They are much, much cheaper. Also, Planned Parenthood offers affordable pills, if that's what you take.

And yeah, the healthcare system is f**d.

Getting generics does help, a lot in some cases, minimally in others. In general, I ALWAYS go for getting the generic if it's available.

I went to PP for my pills when I first started my job, b/c they charge based on your income. But when my income went up slightly (still not much), the price bumped up into nearly what I'd pay at a pharmacy. When it's taken into account that the only PP in my county is 30 miles away, I wasn't saving anything by driving 60 miles round-trip to pick up pills for marginally cheaper.

Also, my work insurance doesn't cover contraception, even though it became illegal in my state to not cover contraception a few years ago.

[spokes]

some of thses things may not be Aetna's fault:

1. If you are talking about an employer sponsored health program - your employer would have most likely made a choice to change the co-pay. obviously increased co-pay's mean lower plan expenses. if your employer made this choice then and they did not inform you that is poor er/ee communications. Alternatively it is possible that Aetna made a "business" decision to make a change on all of thier policies. Either way is is poor communication that they did not provide you with 30 to 60 days notice of this change

2. If I am reading your rant correctly it appears the price of the drugs increased - I don't see that as being Aetna's fault - the cost of pretty much everything we use increases every year. Did your co-pay also change or is there some type of cap on the cost of the drugs in question.

Healthcare inflation can run at 4 to 5 times the genral cost of living expense increases. Additionally I would note that many employer sponsored plans consider drugs like birth control, smoking cessation and erectile dysfunction drugs to be "lifestyle drugs" and they do not provide any coverage.

[EmberMae]

My fiance has Aetna through his company. The copays for our plan didn't change, but the premiums went up & we switched to a plan with higher copays because it saved us $600 a year in premiums and we don't think the higher copays will cost us that much since we don't do dr visits that often. I think it might be up to your employer if you get it through them. I agree though that the cost of healthcare is truly ridiculous. We are paying $2400 a year for two 25 year olds who have never had a serious illness and are perfectly healthy, plus his company claims they're paying another $10,000 on top of that, which is totally absurd.

[embrassezla]

I've got aetna as well so I'm feeling ya, Winter. I can still get my (not available in generic) BC for $15 a month, though, so PM me if you want a tip on that.

[Syracuse]

Yeah things raise in price due to inflation, but that should be 3% about, but medical prices rise 30% each year, ridiculous. I love how repubs always try to spin this though, not sure why. Socialize health insurance, everyone's prices go down. This industry is out of control and needs to be regulated.

[beeblebrox]

I've got aetna as well so I'm feeling ya, Winter. I can still get my (not available in generic) BC for $15 a month, though, so PM me if you want a tip on that.

I'm just curious. Do you guys notice a difference with the generic versus formulary of BC? When I needed to get a new prescription, I couldn't make myself switch to a generic because it's been five years with the same brand name and no problems, so I didn't want to take a chance on bc and suck up the cost.

[mishl982]

I'm just curious. Do you guys notice a difference with the generic versus formulary of BC? When I needed to get a new prescription, I couldn't make myself switch to a generic because it's been five years with the same brand name and no problems, so I didn't want to take a chance on bc and suck up the cost.
I was wondering the same thing. With all my old bc (I've changed brands a lot) I've been fortunate they come in generic, so I would always go with that right away and not get brand name. But I like my current bc, and it does not come in generic. If it ever does, I'm not sure I want to switch to generic because I don't know if it will affect me differently.

But then again I always use Target brand of whatever medicine and it seems to work the same!

[sparky88]

I'm just curious. Do you guys notice a difference with the generic versus formulary of BC? When I needed to get a new prescription, I couldn't make myself switch to a generic because it's been five years with the same brand name and no problems, so I didn't want to take a chance on bc and suck up the cost.


I avoid the generic versions simply because of "fear of the unknown". I've had very little side effects on my current BC (OTL) and have heard complaints from other women who took the generic version of this drug and had much more weight gain, etc. I stick with what I know works for me. My insurance does not pay anything for it, so it is $50/month out-of-pocket. It's less than we'd spend on condoms otherwise, so whatever. =)

[Winter Storm]

I don't think they make a generic Nuvaring yet. And it doesn't matter. The whole inflation-healthcare costs crap is all aggravating.

I don't care whose to blame. I hate 'em all!

[mishl982]

Hehe yea, I try to avoid the dr's at all costs unless it's major because I hate the freakin copay.

I remember the good ol' days when it was $10 a visit. And my parents paid for it! LOL :p

[Kitty]

I'm pissed right now because my insurance is supposed to cover any "speciality" doctor services as long as my primary doctor gives me a referral. Well, I just got a $200 bill in the mail for seeing a dermatologist. Ass holes. Now I have to deal with calling and arguing with them. Not fun.

[Syracuse]

I'm pissed right now because my insurance is supposed to cover any "speciality" doctor services as long as my primary doctor gives me a referral. Well, I just got a $200 bill in the mail for seeing a dermatologist. Ass holes. Now I have to deal with calling and arguing with them. Not fun.
Yup and they will put you on endless hold and hope you give up and just pay it. Sucks.

[wordsmith]

I'm just curious. Do you guys notice a difference with the generic versus formulary of BC? When I needed to get a new prescription, I couldn't make myself switch to a generic because it's been five years with the same brand name and no problems, so I didn't want to take a chance on bc and suck up the cost.

Definitely. It took many trial-and-error and persevering through a lot of bad side effects to finally find a BC pill that "agreed" with me, and didn't cause any problems, and there's a TON of trepidation involved in the prospect of "messing with what works," in that dept. It also happens to be one of the more costly brands on the market. :rolleyes: But what can you do, it's not like the difference between Advil and dollar store ibuprofen, which is nonexistent.

[embrassezla]

Generics have to have the same active ingredients as their brand-name counterparts, which means that only the other stuff like binders can be different. These can cause side effects, but they are usually super minimal, like a metallic taste in the mouth, etc. They shouldn't cause other side effects commonly associated with BC like nausea, weight gain, mood swings, etc.

[embrassezla]

I don't think they make a generic Nuvaring yet.
They don't; that's what I use too. I get it for $15/mo through Aetna's mail order Rx program.

[Winter Storm]

They don't; that's what I use too. I get it for $15/mo through Aetna's mail order Rx program.

Just looked it up. I'm switching to home delivery. Today!

[embrassezla]

Just looked it up. I'm switching to home delivery. Today!
Seriously, it's cheaper AND you don't have to move to get it. Brilliant.

[arrow]

Yup and they will put you on endless hold and hope you give up and just pay it. Sucks.


Heh, I find that whenever I go to the doctor I end up having to call the insurance company at least twice for whatever stupid reason. I think they do this on purpose.

I have Aetna also, btw. They are very friendly on the phone but I'd rather not talk to them at all.

Just think... it you aren't employed, you have to pay WAY more for health care or insurance, just at the time in your life when it's least affordable. And then if you get cancer or diabetes or some other disease while not on insurance, insurance companies will refuse to cover you. I understand the reason, but it's still a bunch of crap. Also when young and healthy people aren't covered, they aren't paying into the system, which drives up prices esp. if large numbers of people with insurance are sick or elderly. This system must change. Access to affordable and available health care should not be an option or a luxury item. And what the hell is up with not covering birth control?

[Trillian42]

What really sucks is the healthcare providers charge more when you have insurance. I had a surgery when I was in my teens and it cost my parents about the same out of pocket whether or not they used their insurace! :eek: (Costs were covered by insurance)

[beeblebrox]

What really sucks is the healthcare providers charge more when you have insurance. I had a surgery when I was in my teens and it cost my parents about the same out of pocket whether or not they used their insurace! :eek: (Costs were covered by insurance)

we haven't even begun to rant about claims either. I have United Healthcare and they rejected a claim for something that they cover (eye and contact exams) and it took forever to get it even looked at. I had to resubmit the information and still haven't heard from them. They're like a ex-boyfriend that you hear from time and time and want to punch everytime they say something to you.

[wordsmith]

Generics have to have the same active ingredients as their brand-name counterparts, which means that only the other stuff like binders can be different. These can cause side effects, but they are usually super minimal, like a metallic taste in the mouth, etc. They shouldn't cause other side effects commonly associated with BC like nausea, weight gain, mood swings, etc.

Is there a generic of Ortho Tricyclen Lo? Because my PP doesn't carry it. And I don't want to have to switch to another formulation just to get the generic. That's the issue. The formulation of Ortho Tri Lo works well for me.

[Trillian42]

They're like a ex-boyfriend that you hear from time and time and want to punch everytime they say something to you.

HA! LMAO!!

[wordsmith]

we haven't even begun to rant about claims either. I have United Healthcare and they rejected a claim for something that they cover (eye and contact exams) and it took forever to get it even looked at. I had to resubmit the information and still haven't heard from them. They're like a ex-boyfriend that you hear from time and time and want to punch everytime they say something to you.

This actually really makes me homicidal. If you pay for coverage for agreed upon services, there is no way in fuck that you should have to FIGHT to get the coverage that is owed you. What's the goddamned point of insurance?

[arrow]

What's the goddamned point of insurance?


They're a for-profit business. Their whole purpose is to make money.

[WorkInProgress]

They're a for-profit business. Their whole purpose is to make money.

And I'm ok with that as long as they don't do what they can to cheat people out of the services that they owe their clients.

[embrassezla]

Is there a generic of Ortho Tricyclen Lo?
I'll ask my pharm (mom).

I don't want to have to switch to another formulation just to get the generic. That's the issue.
That's definitely an issue with BC in general - they affect people so differently that once you find one that works for you, you are advised to just stick with it.

[wordsmith]

They're a for-profit business. Their whole purpose is to make money.

Right, but why don't you have to do that honestly, like any other business?

Not providing people with the service they've purchased is dishonest, fraudulent, really. Which brings me back to my earlier point, that you shouldn't have to fight to get agreed upon service paid for.

[pisces2473]

I was on the regular version, and then the generic came out of mine, and I was fine.

I'm on LoOvral.

[wordsmith]

I'll ask my pharm (mom).


That's definitely an issue with BC in general - they affect people so differently that once you find one that works for you, you are advised to just stick with it.

Cool, let me know. Even if my Planned Parenthood doesn't carry it, if I can get it from a local pharmacist, the generic version may cost less in the long run than driving 60 miles to and from PP for the barely discounted name brand.

[vxmike]

And I'm ok with that as long as they don't do what they can to cheat people out of the services that they owe their clients.

Insurance is a scam. They all try to avoid paying claims that we legitimately pay our premiums to have covered. Auto, health, home, etc. All a giant fucking scam!

[red]

besides the premiums going up this year, my peeve (with United) is that my copay to see a specialist went up from $30 to $35. the term "Specialist" includes my shrink, a physical therapist, an OBGYN, etc. anyone but my "primary care physician" who is too busy/often not suited to really help me. I nearly went broke over the summer when i needed PT.

[pisces2473]

besides the premiums going up this year, my peeve (with United) is that my copay to see a specialist went up from $30 to $35. the term "Specialist" includes my shrink, a physical therapist, an OBGYN, etc. anyone but my "primary care physician" who is too busy/often not suited to really help me. I nearly went broke over the summer when i needed PT.
Yeah, I love it...I see specialists more than my PCP. I can't tell you when was the last time I saw my PCP.

[Winter Storm]

Yeah, I love it...I see specialists more than my PCP. I can't tell you when was the last time I saw my PCP.

Aww, fuck, I better check on that too.

[wordsmith]

I can see NO specialist without a primary care physician's referral each and every time (which means an office visit, obv.), or it is totally not covered one cent. And even then, it has to have a case made for being of medical import, i.e. not cosmetic, etc. Even getting referred to a dermatologist for a biopsy to determine skin cancer is considered "cosmetic" if my PCP doesn't go through the formality with my insurance company of referring me to it as a medical necessity. Yes, because having skin cancer is clearly mainly a cosmetic concern. :rolleyes:

[Trillian42]

Yeah, I mad esure the insurance I applied for was "No referral necessary for specialsts." I don't even have a PCP. I haven't found one that I like, and since I see my OBGYN every year, she just performs a general health exam when I'm in.

[wordsmith]

My insurance is through my work, so I don't have a lot of choice on the type of coverage that it is, unfortunately, unless I wanna scrap it and buy my own.

[Taza Tikha]

Awww, you guys, I just switched to Aetna. Hopefully I won't have any horror stories to share. I have their consumer-driven health plan (CDHP) through my employer. It is a PPO setup that does not require me to name a PCP. Basically, I get a set amount per year (more than what I'm paying in premiums, incidentally) to cover all expenses--office visits, prescriptions, etc. Preventive care (yearly gyno, dental cleaning, eye exam) does not come out of this pot but is still free to me. The idea is that if I have a healthy year, I come out ahead, because not even my prescriptions (right now only bc) will come out of my pocket. But if I exceed the pot (basically, have one major accident or need repeated testing), then I enter their HMO setup and pay a percentage out of pocket. AFTER I reach my $1000 deductible. I made sure to have that in a savings account before I signed onto the plan, just in case.

One downside to the CDHP that concerns me is that I "pay" full price for everything that comes out of my pot. So what would be a $20 office visit copay with an HMO would now be a $250 bill. And, from what I can tell (although I may be pleasantly surprised through mail order), I have to "pay" market price for prescriptions, including Nuvaring. Again, as long as my needs stay the same, I won't actually be paying a penny out of pocket.

I switched because my old HMO, which previously was awesome (including a three-month supply of Nuvaring for $25 total), decided to switch management (making this past year really sucky for getting care) and, now, jack their premiums 20%. I did the math and realize that even if I had to pay full market price out of pocket for BC, switching to Aetna would be less expensive. And maybe if I did end up paying for it out of pocket, it would persuade me to quit once and for all. I don't exactly need it for its intended purpose anymore, but I love love love the control I have over my period. Sigh. Okay, way off topic.

[slimjim]

I am by profession a group underwriter, which means that I set the price for employer paid group insurance coverages, so I need to chime in here.

1). The cost of both your medical & Rx (if through your employer) along with dental, life, disability and long-term care are the direct result of the experience of the plan. Its a simple mathmatical formula: premium for the group plan is developed by comparing prior aggregate claims to total premiums collected and then accounting for trends, expenses, etc.

2). Margins are very slim for insurers. Insurance companies make on average, about 1-5%, if they are lucky. 95% of what you pay goes to cover your claims, the claims of the rest of the group and the overhead expenses of the insurance company.

3) Insurers are not out there "just denying claims". Claims are paid based on the contract between the employer & insuer (which you can obtain through your HR department). Claims are paid fairly and within the guidelines setforth in the contract.

So, why are YOU paying some much for insurance: because that is what it costs to cover the expenses of the plan.

Oh, and why do drugs cost so much. Its called R&D expense. Drug companies pour millions & millions of $ into research and only a one a million drugs gets approval. Then the generics eat away at the drug companies ability to recover their costs.

Last:
Use a Flex Spending Account. You set aside money pre-tax each year use it to pay for medical costs, Rx, even over the counter stuff. Saves a good amount of money.

[capella]

This thread is making me sad. I had really awesome coverage at my old job.. a Cigna PPO plan that was totally paid for by the board. Now I pay (not a lot granted) for a crappy local hospital system plan that doesn't even cover me if I'm not within the system. It sucks.

My insurance doesn't cover ANY non-generic BC. I was on nuvaring and now I have to switch to some pill form. And the pill form was making me all moody and crazy sensitive. I have bad reactions to BC.

I wish I could just not take it. :mad: I can't wait for the day that S gets the boys snipped and I can be hormone free!!! That'll be the day. There is actually a specific list of BC that is covered by my insurance. If it ain't on the list, then I don't get it. I've had to pay $50 a month since August to keep my nuvaring going. I am out of refills though and it's time to go get poked and prodded (which I friggin' HATE). So now I have to figure out A. how I can actually see a REAL gyno and not do the whole your PCP can do it song and dance, B. Go to the frickin' doctor, and C. Take the "approved" list so that I get the prescription for the right thing.

I hate my school board. This district blows. :mad: :mad: :mad:

[beeblebrox]

3) Insurers are not out there "just denying claims". Claims are paid based on the contract between the employer & insuer (which you can obtain through your HR department). Claims are paid fairly and within the guidelines setforth in the contract.

I did everything that they asked (wrote out all of the information that they asked for) for and called my HR when I was filing the claim to make sure that it would go through fine and to have the right claim form and I still got denied!!!! It will be time for next eye appointment before my claim will be accepted and then time for the wonderful experience all over again.

[spokes]

those claims are processed by people and sometimes when claims are processed people make mistakes.

earlier someone mentioned socialized medicine as being a cure - i can say that this is not correct. Socialized medical coverage provides everyone with some type of basic coverage, however, it shifts the costs of medical coverage to the taxpayer. if one were to start looking at the health care costs in canada it is easy to extrapolate the line and see the the system in it's current form is only sustainable for about anotehr 15 to 20 years before health care costs become the biggest chuck of tax revenue leaving little money for other stuff the gov't needs to do (i.e. take care of roads).