Drug Costs and Medical Charges Are Out of Control

Navigating the US healthcare system can often feel like an exercise in frustration, especially when it comes to understanding the barrage of statements, bills, and charges that seem to come out of nowhere. Despite opting for email communications, the paper trail doesn’t seem to end. It’s a good thing I’m generally healthy, just dealing with the usual wear and tear that comes with getting older.

Although I didn’t change insurance this year, I defaulted to retaining my AARP United Healthcare Insurance top-up policy. I also stuck with Wellcare for my “Part-D” drug plan, but Wellcare switched how the prescriptions are filled, they switched from CVS Caremark to ExpressScripts. All of my heart meds’ are covered, with just two costing $4.99 per 90-day refill.

I recently had problems with an infection inside one of my eyes. Asides from dealing with United Healthcare over the costs of some of the optician visits, it mostly only required drops. One of the very small bottles of drops had a $49 co-pay, in part I suspect because I collected it from a local pharmacy rather than wait 3-5 days for it to arrive in the mail.

Then yesterday I listened to this NY Times article in the car. Their Android app does a great job at doing text to voice translation. Suffice to say, neither CVS Caremark or ExpressScripts come out of it looking good. If you have not read/heard it, this is a gift link and should bypass the paywall.

NY Times (gift article) The Opaque Industry Secretly Inflating Prices for Prescription Drugs

Surprise Charges

Every time I go to a medical office for any kind of visit, I’m asked to sign a “No Surprise Billing” form. However, since I have no idea what the provider will bill my insurance, and what my insurance will pass on to me in co-pay, deductible and out-of-network charges, it’s always a surprise, even when I don’t get a bill.

Today Dr. Ofri, a primary care doctor in New York offered this frank and very confirming op-ed on “surprise billing”. Again it’s shared below as a gift article that should bypass the paywall. Have you ever heard of HOPD’s? I have now.

As of 2022, federal law protects patients from surprise bills if they are unknowingly treated by out-of-network doctors. But there is no federal protection for patients who are unknowingly treated in higher-priced hospital affiliates that look like normal doctors’ offices or urgent care clinics.

NY Times (gift article) Even Doctors Like Me Are Falling Into This Medical Bill Trap

Have a great summer! I’m trying to stay out of politics, hopefully I can…

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