CoPays

TAP wrote about stupid people who complain about their drug co-pays because they don’t read their insurance policy.

I don’t complain, but I have asked questions a couple times.  Because I do read my policy.  It quite clearly states that my co-pays increased this year.  Drugs on the $5 list went up to $10 (most of my meds), the $20 list increased to $25, and according to my insurance company if I happen to need a medication in the most expensive category, it will now cost me $50 instead of $40.

This policy, however, doesn’t translate into the real world.

I understand that methotrexate increased to $7.40 over $5.60 because my dose increased.  Yes, this is less with insurance than the cash price of $21/$14, and I appreciate it.  What I don’t understand is why it’s not $10 or $25.

Why $3.80 for ibuprofen or $3.86 for piroxicam?  How does that $10 co-pay sometimes become $7.25 or $3.10 when the cash price of the drug is well above that amount?

Is all of this to keep me from squawking when I’m charged $10.99 every month for my plaquenil?  It works.  I pay that extra $12 per year because it seems like I’ve saved even more on other meds.

Read my policy on prescription benefits?  Definitely.  Understand what the pharmacy charges?  Not a chance!