Health Insurance Scam!
Without knowing it, many of us are now complicit in a scheme to rip off government health care systems. It is being used as a scam by insurance companies to rip-off a patient’s account to monetarily rip of the system. The vimovo story below illustrates this perfectly.
My doctor prescribed Vimovo from AstraZeneca for my residual back pain that resulted from a fall from a two-story balcony last summer. My husband and I pay approximately $260 per month for insurance so we were a bit surprised when the pharmacist informed us that that there was a required co-pay of $60 for the 30 pills; especially since our yearly deductible had been covered completely for months now. We were both physically taken-aback when the pharmacist informed us that the full cost of prescription was $1700.00. Yes, you read that correctly – Seventeen Hundred $$. I could not even begin to believe that a pain pill for minor back pain could cost such an incredible amount; way more than my monthly social security stipend.
I began to do some digging. I found two shocking details:
1) My friend in Canada could purchase the exact prescription for $54. That meant that I had just paid the full price for my prescription with my copay, plus $6.00.
The insurance company was keeping my insurance premiums for the month without laying out anything. I paid for my own prescription (they called it a co-pay) and then used me to collect $1700 additional dollars from Medicare.
2) Vimovo is actually a simple combination of two common, over-the counter, already approved medications: Naproxen and Nexium. I can purchase the exact dosage of Nexium for a month’s supply for $23.99; Naproxen’s month supply is on the $4 list at Walmart. I could EXACTLY duplicate a month’s supply of Vimovo for $27.99. Even at those retail price there must be some profit being made. There is little or no research that would be required for Vimovo; both of these over-the-counter drugs have already been approved; likely by several government agencies. Someone, somehow has approved a scheme to use people’s need for medications to create a scam to outrageously inflate drug prices; allowing the milking of the Medicare system by unscrupulous drug companies who are likely in bed with the government scoundrels who are allowing this to happen.
Prices are going even higher!
See the attachments below I did just this week. These are for 60 pills, I think.
Another example:
Bill rented an oxygen machine for the last 3 years or $75 a month ($2700 in total) for a machine that costs under $600 but can’t be purchased outright by the patient. The medical supply house approached Bill and wanted to change from personal pay to insurance pay. They required a $5000 plus sleep study and ended up changing the month fee to $17.62. Shortly thereafter, Bill discovered that not only was he paying $17.62 but the supply house was billing the insurance company an additional $270 per month. Not only had the machine been paid for four times over by the patient but the insurance company was getting billed 15 times more than the self-pay amount.
Medicine Supply Distribution Companies are likely some of the most outrageous schemes out there – a company called my home to ask if I used any medical supplied on a regular basis. They suggested if I would sign-up with them, they could get supplies far less expensive. I really didn’t need anything but was curious – they would purchase supplies and/or meds, I would pay a small fee and they would bill Medicare for me. Turns out, my small copay was paying for my meds and they would turn around and use my name to collect outrageous amounts from Medicare. PillPak and similar companies claim that processing medication this way increases patient safety and compliance.
