I still don’t fully understand why my insurance caused my prescription drug costs to go up 83%.
Today I talked with a representative from express scripts, the company that services drugs for Anthem Health Care. The representative repeated ad infinitum that their pricing agreements with specific pharmacies were “proprietary information”, but seemed to state that that if the rates from the pharmacy were lower than the insurance company dictated rates, that I should end up paying the lesser of the two prices, not the greater. That makes sense to me, but that isn’t what ended up happening.So my pharmacy, who blamed my insurance company, who blamed its prescription drug program operator, has now blamed the pharmacy. The circle is complete!
Why the obsession about their drug pricing being “proprietary”? Did I sign a NDA when I bought my drug? Is a pricing NDA buried in the fine print of my health insurance plan? If I trumpet the fact that their drug pricing is horribly inflated, are they going to come after me and try to muzzle me? Time will tell.
Now you might say, why am I getting that bent out of shape about a measly $29.37 extra per prescription? It’s because when I was shopping for my health insurance plan, this is what I saw, and what remains on the pamphlet for my plan:
So I am registered on the sites of both these companies. From what I understand of my benefits, after I meet my deductible I pay 0% for in-network pharmacies. So last night I embarked on the quest to try to determine weather the pharmacy that sold me the prescription was in or out of network.
Anthem’s site redirects to Express Scripts for services. But a pharmacy locator is NOT one of the available links. If I search “Express Scripts Pharmacy Locator” google finds this page:
However, when logged in from Anthem, this page only shows only the following error:
Now I’ve received letters from Anthem about how Walgreens is leaving their network, so the only information I have access to is is that the Express Scripts network does not contain Walgreens. But as far as finding a local pharmacy? No help at all. Express Scripts’s site wants me to use their home delivery service to save a measly 3%
So I feel ripped off, here’s why… Lets check out what this medication costs if I source it from somebody other than express scripts:
On the other hand, here is how Express Scripts (falsely) advertises themselves:
Next steps: Going to speak with the Pharmacy one more time, and I am working on preparing my complaint to the Colorado Division of Insurance.