Fact Checked

Health Insurers And Pharmaceutical Companies Are Playing Hardball With Your Health

Health Insurers And Pharmaceutical Companies Are Playing Hardball With Your HealthDrug manufacturers (and the third parties along the supply chain) want people to pay as much as possible for their medications. This is an understandable desire on their part, even if most people wouldn’t praise them for trying to extract money from sick patients, and at least some of the money they take in does make its way back into medical research.

At the same time, however, health plan providers want to pay as little as possible for treatments and medication. This is also understandable, since they have to balance high medication costs with affordable premiums. Before the Affordable Care Act, insurers would reach this balance by doing things like dropping clients who had serious medical conditions, even including pregnancy, and then refusing to cover them later thanks to their “pre-existing conditions.” They would also sell plans with little to no actual, practical coverage.

But since the ACA now prevents insurers from using these money-saving tricks, they’ve come up with some new ones. For instance, CVS Caremark and Express Scripts, the two biggest prescription drug insurers, have a list of excluded drugs, medications which their plans simply don’t cover. Exclusion is used as a tough negotiating tactic to get better discounts, especially on the new brand-name drugs with astronomical prices. By focusing on biosimilar drugs and other competition, the insurers hope to drive down medication prices.

Unfortunately, medication insurers don’t always have a covered alternative for their clients. This means that patients either have to foot the bill themselves or else go without the treatments that could potentially save their lives or at least get them to start enjoying life again. Medication insurers are at least trying to reduce prices for their clients, but between them and the pharmaceutical companies, a lot of patients are getting squeezed.

Fortunately, while USA Rx may not have the steepest discounts, we also don’t use exclusion as our preferred tactic. With our pharmacy discount card, you can count on paying up to 75 percent less than the list price on prescription medications both generic and brand-name. Signing up is quick and easy, and once you present our card to the pharmacy of your choice, you’ll be able to choose whichever option is cheaper between our discount and your insurance copay. If you want to find out more, give us a call at 888-277-3911 or send us an email at [email protected]