Healthcare

The cost of Insulin, health insurance and missing the point

Fact: the list price of insulin has increased significantly in recent years. The cause can be attributed to lack of competition among manufacturers, to improved medication, to increased costs. Nevertheless, it’s expensive and easily can be called unaffordable for some people if they actually paid the $500 a month retail price. But keep in mind the retail price is rarely paid by anyone.

A day ago I was listening to NPR doing a story on the cost of insulin. They interviewed a 21 year old college student with type I diabetes using an insulin pump. The cost of her medication had rising in one year from $200 a month to $500 she stated and was not affordable. She related an array of steps she had taken to get through the year from free samples from her doctor to sharing with her father and using the supply of a friend who had died.

But then she said her health insurance had a $6,000 deductible which meant she was on the hook for all her medical care and medication for the year up to that amount. She had traded her known costs for lower premiums. Even with a high deductible, it’s curious as to why she was charged the retail price as opposed to negotiated price used by her health plan which is the amount that would be applied to her deductible. These stories tend to omit facts along the way.

In January 2018 things changed dramatically. She enrolled in a new health plan through Obamacare. Because her income is only $12,000 nearly all her premium is covered by tax credits she said and she no longer has a high deductible. Her insulin has a $25 per does co-pay.

Problem solved‼️

You can bet her health plan is not paying anything close to $500 a month for her insulin. What has really changed is that the total cost for her health care has been shifted to taxpayers and other individuals enrolled in her health plan.

The change she made was prudent and reasonable for her, but no problem has been solved.

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4 replies »

  1. I did not myself compare plans but the person I spoke with had. As I I understand it, the state does not kick in any money, all premiums are paid by the retiree. While the State of Washington is run by one party, and is considered true blue, employees and retirees are not highly paid although health benefits while still employed are good.

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    • I looked the premiums up on their website and it does appear retiree pays the full cost. Those are pretty average premiums for that age group, but takes quite a bite out of a pension. Not typical of state benefits though.

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  2. The world of health care insurance is often bewildering. This past week I spoke with an employee of Washington State’s Health Department who showed me the premium schedule for the various plans offered to public employees in Washington who are retired. To my surprise, many of the plans are far more expensive than those offered on the commercial open market. While some states may provide relatively inexpensive health insurance to state retirees, Washington is not among them. All the plans require Medicare participation by th way.

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    • Did you compare the benefits? Are they self-funded? Do they include generous Rx Benefits? No state that I know of provides inexpensive plans, some just charge retirees less or nothing in a few cases.

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