insurance

[hogswin]

Do almost all pharmacys ck to see if you have ins even if u specifically tell them u do not n want to pay cash.

[philnoir]

We're talking about two different things here.

At some pharmacies (like Walgreens), they are trained to consider a patient who pays cash for a controlled substance Rx when that patient has insurance as one indication of "doctor shopping."

This is why it's good to have a relationship with your pharmacist, so that misunderstanding does not occur if you have other reasons for paying cash instead of using your insurance.

For instance, I needed a 2-day supply of my long-acting opioid (the doctor miscounted), so I asked my pharmacist to run it through without insurance, because I knew in 2 days, I'd be submitting an Rx for a 30-day supply. I did not want the insurance company to refuse payment on the larger Rx because they had just paid for a small quantity.

The other thing BetterGetBetter is talking about vis-a-vis doctor's visits is called a capitation agreement. Insurance companies negotiate prices with practitioners to limit (or capitate) their costs. When you don't have insurance, the doc or hospital can charge whatever they want, but with insurance, they have to stay to the agreed upon rate.

This makes no sense at all when we're talking about medical care as a right, and looking at who can afford to pay and who can not. Never forget that medicine is a business, just like any other, and will always be governed by so-called "market forces," (until we as a people say "enough is enough" and change it at the ballot box.)

[BetterGetBetter]

Good question, and good answer. Sometimes I wonder about that because many times I do NOT want insurance to be used. Why? Because sometimes you get a seriously cheaper rate if you go in and say you are a cash pay.

My eye doctor will do a quick check for "dust" in my eye for $50, but when I accidentally told them I had insurance, they charged almost $200, and when I told them NOT to use insurance, they lied and said that insurance made them promise to use insurance.

As far as pills and medicines, if you got a good plan, why not use insurance? If it's cheaper w/o insurance, a "normal" person would say "NO insurance on this one, Mr. Pharmacist," but, I am a realist, and I do understand this may "red flag" people sometimes..... maybe.... is this a conspiracy theory? Me thinks we will never know. Honesty and straight-forwardness and truth is always the best policy in the long (sometimes really long) term...

[trixy71]

However, if you really don't have insurance, then after they do their checks, there should be no problems.

[trixy71]

Usually, yes, because telling a pharmacy that you want to pay cash, almost always will send up a red flag, if its a narcotic prescription. When someone does that, the pharmacy will become suspicious and think you are trying to hide something and they more than likley won't even fill it for you. Its not a good idea to do that if you have insurance.

They now have databases that show every narcotic prescription that you ever filled, when it was filled, where it was filled, the doctor that prescribed it, the amount of pills, the day it was picked up, how it was paid for, etc. So its not worth even trying to get around it because they will know once they check the state database. And believe me when I say this, they always check.