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To save money on prescriptions, try putting away your insurance card
Want to save money on your prescriptions? You might try putting away your insurance card and paying cash.
We’ve been writing about this for years, but academics seem to discover this on the regular as a surprising new fact — most recently academics at The University of Toledo College of Pharmacy and Pharmaceutical Services.
Many people think their insurance premiums give them access to the lowest prices for prescriptions and procedures, but that is far from universally true. One study finds “79% of the time Part D patients who haven’t yet met their deductible can get their drugs cheaper by paying cash than by using their insurance and paying the price ‘negotiated by their PBM.’”
Urgent care will see you now, but be careful
A lot of people are using urgent care centers for health issues – and some are finding that the results are less than perfect.
An internal medicine doctor kicked off the discussion on Facebook: “I’m curious if any patient gets anything besides Z-pak and steroids from Urgent Care. Does not seem to matter what the chief complaint is.”
Another chimed in: “You guessed it/ Z pack and steroids for ‘stomach flu.’’’
As colds, flu and RSV surge, with Covid rising in many places, it’s hard to get a doctor’s appointment, either with a primary care physician or a specialist – and sometimes urgent care is your only option to be seen outside of the emergency room.
So if urgent care centers fill a need, what’s the problem?
The staff of urgent care centers is probably not an M.D. or D.O. Staffs are 84 percent advanced practice providers, like nurse practitioners and physician assistants, according to an article in the Journal of Urgent Care Medicine. Doctors say that these less qualified clinicians often are in a hurry and may default to a kneejerk “here’s a Z-pak,” even if that’s clearly not helpful from a fully trained doctor’s perspective.
How much does Paxlovid cost? $0 or $1,600?
Now that the antiviral Paxlovid is no longer routinely covered by insurance or by the government as a Covid treatment, can you get it free? How much will you pay?
Well, it could be free, we learned. Or it could be $500 to $1,400. Or it could be $1,600 or $1,500 — or $6.50, or $75.90 for the standard five-day dose. As with so much in the U.S. healthcare market, it depends.
Don’t trust that Covid test: Now, as before, they are unreliable
It’s a story as old as the pandemic: “He tested negative, but I’m sure he has it. What should I do?”
The topic has come up repeatedly — with at-home rapid antigen tests (RAT) and the more sensitive PCR (polymerase chain reaction) and molecular tests like Lucira. Not long ago, it came upon in a Facebook group, where the anonymous poster wrote that she and her daughter got Covid for the first time, but her husband, who has been sick for weeks with the same symptoms, repeatedly tests negative. His doctors say he has it, although he is negative, she added.
Others chimed in with similar stories. Here’s what you need to know.
Medicare Advantage vs. traditional Medicare: Two stories of a successful switch
Switching out of Medicare Advantage, the private version of Medicare, into traditional Medicare with a Medigap plan is not always easy.
Recently I connected with two men who made the switch successfully. Here are their stories — plus a list of the things that can be denied because of prior authorization. It will make you think.
In Medicare Advantage, the privately run program parallel to traditional Medicare, for-profit insurers get paid by the government to insure older Americans. Medicare Advantage plans may have lower premiums than traditional Medicare, but they also have smaller networks and require prior authorization. Traditional Medicare often has holes in coverage too, so enrollees often buy a supplemental Medigap plan to cover the costs that traditional Medicare does not pay, and also a Part D drug plan — getting more choice. But switching out of Medicare Advantage can be, well, complicated.
Is Long Covid a remitting-relapsing disease?
Nearly four years after the emergence of SARS-CoV-2, an estimated 65 million people worldwide living with Long Covid still do not know whether recovery is within reach.
Because Long Covid is an umbrella term encompassing diverse experiences, and there is a lack of long-term research, it’s difficult to draw conclusions about the rate of recovery for this illness.
However, patient anecdotes, research into related illnesses, and a recent study examining Long Covid outcomes after two years indicate that the road to recovery is often “long and arduous,” as Long Covid researcher Dr. Ziyad Al-Aly puts it, and experiences of recovery or relief can be precarious and short-lived.
What we’re reading
Drug shortages keeping cancer patients from getting chemotherapy. The New York Times.
She was at an in-network hospital for her quick telehealth visit. So why did she get a massive bill? And what can be done to avoid this? Kaiser Health News.
Doctors unionize as health systems consolidate. Lovely piece from Fred de Sam Lazaro @Undertold Stories for the PBS NewsHour.
Flovent inhalers, one of the most common for asthmatics, have been discontinued and replaced by an “authorized generic.” Yes, it’s all about the money. Stat.
The business of psychedelics. It’s complicated: Ketamine, MDMA, LSD, mushrooms? The Wall Street Journal.
Even people with good insurance are not guaranteed affordable care. Read and weep. KFF Health News.
5 percent of people account for half of all health spending. Peterson-KFF health tracker.
Paxlovid cuts health risks — but the people who need it aren’t taking it. The New York Times.
About half of all Americans say they have trouble with health costs. Kaiser Family Foundation.
