Published on October 11, 2017
An interview we did back in April may now be more relevant than ever!
Stacey L. Worthy, Esq, executive director of Aimed Alliance, The Alliance for the Adoption of Innovations in Medicine, told us that the organization has a program to help patients work around barriers to access. This includes high copays or such practices as step therapy, where insurance companies require an older cheaper medication before they’ll reimburse what your doctor prescribed.
But if we’re skeptical, how much can we really do about our own prescription costs?
How much, you ask? Looking through this week’s news, one headline from Lodi, a California community south of Sacramento, gave us a dramatic answer:
“HOW I SAVED 90 PERCENT ON PRESCRIPTION MEDICATION.”
We just had to read the details and suggest you follow the link and do the same. But here are the highlights.
The patient, a financial planner named Ken Levy, switched insurance companies and the cost of his meds, in this case for cholesterol, soared to $240 per month, far more than he used to pay.
So he called to complain.
His health-plan rep told him to get a pre-authorization from his doctor. He did and the price dropped to $130 per month. Still too high.
His health plan told him to order through an affiliated online pharmacy, and his cost dropped to $40 per month.
That would have been fine if the insurance company had told him that to begin with. But now he wondered what else they hadn’t disclosed. So he did some research and found that by becoming a member of an online company, he could drop the price to $23 per month. That’s more than $200 per month less than where he had started.
Now we’re not saying this would work for everyone, for every insurance plan or even for cancer medications at all. But it does remind us of our friends at Aimed Alliance. Check out http://coveragerights.org to learn how to work with your doctor and appeal insurance decisions state by state.
Stacey Worthy told us, if your insurance company still won’t budge, coveragerights.org can show you where and how to file a complaint with your state’s insurance commissioner or attorney general because, as she told us, “the more complaints they get, the more willing they are to identify bad actors in the industry and take action …”
As a patient myself, I understand that sometimes fighting your disease is all you can manage. In that case, we recommend you enlist the help of a friend or family member. As Ken Levy found out, the effort saved him more than 90 per cent. And for us, that’s just what the doctor ordered.
As always, I welcome your comments and your own personal stories. You can email me at [email protected].
I wish you and your family the best of health!
Co-Founder, Patient Power
Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
Your site is AWESOME! Thank you all so much for this incredible resource to families who are in crisis/affected by cancer.