12-20-2016, 01:00 PM
(12-20-2016, 12:37 PM)michaelsean Wrote: Not for me. Regular Dr visits and prescriptions aren't affected by my deductible. My son's MRI and surgery were.
I'd love to read your plan. But, this goes back to my complaint insurance companies make it as complicated as possible. I've seen two patients both with BCBS from the same state. But, their prescription plans were different. So the prescription I thought would be covered under BCBS wasn't. So then I had to call the pharmacist and have him enter different medications individually into his his computer program with the patients prescription plan until we found a suitable substitute which was covered at an affordable price. And what is affordable varies from patient to patient. Some can't afford a $20 co-pay.
This type of crap decreases my productivity because no I'm dealing with stupid insurance quirks instead of seeing patients which affects my employer's revenue (which can result in price increases.) Patient's wait times increase. Patients get more irritated the longer they have to wait. The patients miss more work and lose more income the longer they wait.
I live near a state line so the preferred medication (or tier level) may be determined by the patient's geographic location. For example, two similar patients both with pneumonia. I want to prescribe a fluoroquinolone. Both patients carry BCBS, but on different sides of the state border. The fluoroquinolone preferred (tier 1) in State X for pneumonia is Levaquin. The fluoroquinolone preferred (tier 1) in State Y is Avelox. The reason one fluroquinolone is preferred (tiered higher) over the other is favorable prices negotiated between the drug company and the insurance company.
Some insurance companies have reserves in the bank which far exceed their insurance liability. No one is ever going to make me believe we don't pay enough for health insurance.
