Insurance company (United Healthcare) hardball tactics

[StarChild56]

This video must stay on YouTube.

My gosh I have no words, I am so sorry. Hugs.

 

[Gingergrrl]

We are all tracked by multiple companies. There was a segment on 60 minutes about it last Sunday--they suggested that the US might do well to adopt privacy laws like the new EU's GDPR which have many levels of citizen protection. Sorry to go off topic but insurance companies also track us.

I know we are tracked by every move we make on the computer & phone but I hate to give additional info to YouTube if I can avoid it . What is EU GDPR?

I think you can not see where to like videos there due to you are not signed into youtube. I leave myself signed into there all the time as it has the handy thing of automatically keeping track of ones viewings and will then list recommendations of other things there to watch based on what you like to do there.

It's so weird, Tania, b/c I can see the "thumbs up" and "thumbs down" signs as well as where it asks you to "subscribe" and the YouTube App on my phone tracks everything that I watch and makes recommendations to what it thinks that I want to watch (which is how I get sucked into watching so much)!

But it doesn't let me like or dislike a video, I cannot see the comments, and I cannot subscribe. I asked my step-daughter about this tonight and she said you have to be signed in through Google, Facebook, etc, which I am not. I asked her if you can just sign into YouTube itself (without being signed in through another entity) and she didn't think so but she might be wrong or I might just be confused!

My gosh I have no words, I am so sorry. Hugs.

Thank you my friend

 

[Gingergrrl]

I am not sure if I already said this but I want to thank the person who made the original YouTube video exposing United Health Care. It is an excellent video (very impressive) and you were very brave to make it and post it and share your story. I am sorry that UHC is trying to force you to take it down. (If you are a PR member, I hope you are able to read this message of thanks but please do not reply and keep your anonymity). I just wanted you to know that I appreciated the video very much.

 

[Sushi]

What is EU GDPR?

It is a comprehensive (and very complicated!) set of privacy protections that cover anyone in the EU. It became active last May. You may have noticed that many websites you visit ask you to accept a new privacy policy. This is due to the GDPR as any organization or company anywhere in the world that has interaction with EU residents has to comply.

In the next few weeks you will need to accept PR's new privacy policy when the XenForo upgrade goes into effect.

 

[liverock]

I used to regularly be able to access the LA Times website from Europe but no longer.
It seems that over 30 of the top US 100 news sites are not complying with GDPR and are therefore blocked to Europeans.

 

[Gingergrrl]

I used to regularly be able to access the LA Times website from Europe but no longer. It seems that over 30 of the top US 100 news sites are not complying with GDPR and are therefore blocked to Europeans.

That is a bummer and I wish you could still access those websites! I had not heard of GDPR before and am wondering if it was too complex for some of the websites to follow (or if they were just being lazy)!

 

[jesse's mom]

@Gingergrrl has a really good question!
I guess I just realized years ago that Big Brother watches us, I feel like such a tiny person in this vast world that it stopped bothering me. Just got complacent... Good thing I am not a criminal, I would have gotten caught for sure!

On the medical insurance issue, my mother is so concerned about her insurance rider becoming aware of her aging that she sprained her ankle really badly a couple of months ago and would not go get an xray! I thought she was being a little nutty, but maybe she is right!

Now that I have medicare my rider is paying less and less, at this point it is just paying for medications, but that is a lot! My migraine medicine alone is $100 a dose! Our medical policy family monthly premium is more than our house note!

See why I can't watch much news? I get a little nutty myself!

 

[Gingergrrl]

@Gingergrrl has a really good question!

What was my question?

On the medical insurance issue, my mother is so concerned about her insurance rider becoming aware of her aging that she sprained her ankle really badly a couple of months ago and would not go get an xray! I thought she was being a little nutty, but maybe she is right!

What does "rider" mean? And I am sorry about your mom spraining her ankle and feeling that she could not get an x-ray. How is she doing now?

Our medical policy family monthly premium is more than our house note!

My monthly insurance premium was insanely high but luckily I will no longer have this plan in 2019 and am going back onto the insurance of my former employer which is very reasonable. (It would still seem high to those outside the US but for us here, it is going to save me about $800 per month).

 

[jesse's mom]

What was my question?

I forgot!

What does "rider" mean? And I am sorry about your mom spraining her ankle and feeling that she could not get an x-ray. How is she doing now?

This is her language, she is on medicare.. she called the supplemental insurance from the school system, Her old job, a "rider". She is in her mid '70s...

 

[valentinelynx]

There are many companies that are not greedy and abusive but the lousy ones make me suspicious of all of them until they prove otherwise

I honestly do not believe this applies to health insurance companies. If you look at each company's review online you see the exact same complaints about all of them, and they all have one star averages! The business model is to take your money and avoid paying benefits any way possible. It is only when abuses come to the attention of major media or insurance commissioners that there is possibility for change.

Aetna in California was recently handed a $25 million punishment for denying the standard of care (proton beam radiation) to a woman with a certain kind of brain cancer. Aetna had also recently come to the attention of the California Insurance Commissioner for admitting in court that the medical director never looked at patient's records before issuing a denial; he would just go with the evaluating nurses' opinions. This was in a case involving a CVID patient needing renewal of his IVIG authorization; something that strikes close to home for many of us!

 

[Gingergrrl]

The business model is to take your money and avoid paying benefits any way possible. It is only when abuses come to the attention of major media or insurance commissioners that there is possibility for change.

This pretty much sums it up

 

[Gingergrrl]

Speaking of insurance issues, I was at CVS tonight picking up a prescription (which they screwed up but that is another story) and the woman next to me was told that her medication was denied by her insurance who had rejected the Prior Auth from her doctor and it cost $480 private pay. I thought she was going to cry and I wanted to do something but I knew there was nothing whatsoever that I could do.

 

[valentinelynx]

Speaking of insurance issues, I was at CVS tonight picking up a prescription (which they screwed up but that is another story) and the woman next to me was told that her medication was denied by her insurance who had rejected the Prior Auth from her doctor and it cost $480 private pay. I thought she was going to cry and I wanted to do something but I knew there was nothing whatsoever that I could do.

There is one thing... you can usually get a better deal on most any self-pay drug by using the website "GoodRx". You enter the drug you want to buy and make sure you have the right strength and amount of pills (or whatever). The site will then show you a list of coupons with prices for different pharmacies near you. Using this tool can save a lot of money: for example, my insurance just decided to make a pain med I've been taking for 8 years need prior auth. My doctor isn't really set up to do prior auth's so I'm just paying for it. But my husband forgot to ask me for the coupon before going to the pharmacy to pick it up last time. So it cost me $130, rather than the $44 it would have been with the GoodRx coupon! That's $85 I could have saved (and will next time). The poor woman at your pharmacy might have been able to get her med for couple hundred dollars less.

Also, you don't have to have the physical coupon printed out. Just show the coupon on the screen of your phone the pharmacist or assistant can copy the numbers.

I don't really understand the business model, but apparently the pharmacies listed on the GoodRx coupons are contractually obligated to take them. The exception is some nasty pharmacies that have decided to be @sses to pain patients and refuse to allow any discounts for pain medication. How that helps anyone, I don't know. Walmart is one, so avoid them if you need pain meds!

 

[jesse's mom]

It seems that over 30 of the top US 100 news sites are not complying with GDPR and are therefore blocked to Europeans.

For some reasons there are media I could access from Europe, that I cannot any more.

 

[Gingergrrl]

There is one thing... you can usually get a better deal on most any self-pay drug by using the website "GoodRx".

I have never heard of "GoodRx" before and just bookmarked their page on my computer to look at later. At the moment, all of my meds are covered by insurance but I have no idea what happens in Jan (when I have completely different prescription coverage than I do now).

You enter the drug you want to buy and make sure you have the right strength and amount of pills (or whatever). The site will then show you a list of coupons with prices for different pharmacies near you.

Do you know if you can specify the brand or manufacturer that you need when using "GoodRx"? This has been one of the biggest issues for me b/c all of my meds are dye free (due to MCAS). So for each med, it is listed in the CVS computer which one I need (for example whether it is TEVA, Mylan, Mallinckrodt, PAR, Sandoz, etc). I have a generic for every med that I take except for Cortef in which I have to take the brand and Armour Thyroid (which does not have a generic).

This is where CVS often screws up and even though I call and double check so they can verify that they have my brand (or if they need to special order it), they still screw it up. Once I am physically there to pick up the med, I open the bag to make sure it is the correct brand and very frequently it is not (like yesterday). My main doctor even writes "dye free" on the original prescription, in addition to having it in their computer and me confirming on the phone and yet they still frequently screw it up.

 

[valentinelynx]

Do you know if you can specify the brand or manufacturer that you need when using "GoodRx"?

You can select between brand name and generic, but I do not see any way to select which generic manufacturer when printing or selecting the coupon. However, it might work this way (worth a try): print or select the coupon for the generic name of the drug you want to buy, and arrange directly with the pharmacy to order the drug from the manufacturer that you want. I'm supposing that GoodRx's price will apply regardless of the manufacturer. I could be wrong. And if it's the brand name drug you need, just make sure you select that under "Prescription Settings" at the top of the page (after you've selected your drug).

Good luck! Hope it helps.

 

[Gingergrrl]

You can select between brand name and generic, but I do not see any way to select which generic manufacturer when printing or selecting the coupon.

I haven't had a chance to look at it yet but this is what I suspected (and thank you for clarifying).

However, it might work this way (worth a try): print or select the coupon for the generic name of the drug you want to buy, and arrange directly with the pharmacy to order the drug from the manufacturer that you want. I'm supposing that GoodRx's price will apply regardless of the manufacturer. I could be wrong.

This makes sense and since my CVS (I get all of my meds from the same location) knows the generic manufacturers that I need, it might actually work! The generics are actually very cheap any way (in my case) vs. the one med that I must take the brand for (Cortef) is very expensive.

And if it's the brand name drug you need, just make sure you select that under "Prescription Settings" at the top of the page (after you've selected your drug).

Thank you and that makes sense, too.

Good luck! Hope it helps.

Definitely and thank you again!

 

[Gingergrrl]

@valentinelynx I decided to try your website "GoodRx" today (b/c I need to pick up my Cortef refill at CVS) and I typed in "Cortef" and initially I was very excited when it came back with a coupon for $29 at CVS which would have been too good to be true! But then it said it was only for "hydrocortisone ointment" (not the pill form of Cortef). I tried several more times but it seems like the pill form of Cortef is not an option for that website. I wanted to mention this just in case it is helpful to anyone else? I thought it might be there but it either Cortef wasn't a choice or I did something wrong!

 

[valentinelynx]

I typed in "Cortef"

Hey, @Gingergrrl, good news... I tried your search, and I see what happened. While the ointment is the version that came up first, you can get to the tablets by making sure that you have "tablet" selected on the line where you enter "Prescription Settings" (the label is in blue on the left side, under the picture of the drug). The label "Prescription Settings" points to the right, where various drop down menus to select the right form of the drug are listed. It's kind of odd, because it actually appears that for the brand name version ("Cortef") there actually isn't anything BUT tablets available, so I don't know why the ointment comes up first, even when "Brand" is selected rather than "hydrocortisone (generic)". But, you definitely can select Cortef tablets in various strengths and amounts.

The prices I'm seeing for my local pharmacies (Costco, Walmart, Fry's, CVS, etc) are in range of $65 for sixty 5 mg tablets. Here's a link that should go directly to my search findings (but please note that you will have to change the location to get appropriate listings for your local pharmacies. Click on "Set your location" under "Prices and coupons for ___ tablets of Cortef ___ mg."

I hope that is helpful. If you can't get it to work, you can PM me with your zipcode and the number and strength of Cortef tablets you need, and I'll do the search for you.

 

[Gingergrrl]

Hey, @Gingergrrl, good news... I tried your search, and I see what happened.

Thank you so much for the additional info and I figured that I had done something wrong!

The prices I'm seeing for my local pharmacies (Costco, Walmart, Fry's, CVS, etc) are in range of $65 for sixty 5 mg tablets.

Here's a link that should go directly to my search findings

Thank you and your linked worked perfectly. I only use CVS and I just calculated the coupon rate for 60 pills vs. what I paid yesterday without the coupon (for 90 pills). The coupon rate ended up being $1.12 per pill and what I paid ended up being 90 cents per pill which shocked me. I used to pay $136 for this med (and then the coupon would've been much cheaper) but for whatever reason, they are now charing me $81.65 (for 90 pills) which is better than the coupon rate. This med always seems to vary in price when I pick it up and I have no idea why! But in January I will have a completely different prescription coverage so it will be a surprise for every med .

I hope that is helpful. If you can't get it to work, you can PM me with your zipcode and the number and strength of Cortef tablets you need, and I'll do the search for you.

That was so sweet of you to offer and it was very helpful. I didn't even know that website existed before you posted about it!