A recent story about an Arizona couple that faced steep prices for much-needed medication is making headlines. Corinne and Ken have been married for 38 years. Their world was recently rocked by Ken’s Alzheimer’s diagnosis. His doctor prescribed cognition medication called Donepezil; the drug helps with mood and memory, but doesn’t slow or stop the disease. Reeling from the diagnosis, Corinne filled the prescription at a local Walgreens. She was stunned to find out that a month’s supply without prescription coverage totaled a whopping $198.80.
Corinne felt pressured to get the medication to Ken as soon as possible, so she paid and left despite the sticker shock. Later, when she and her family had some time to absorb the diagnosis and development, Corinne began to wonder whether she couldn’t get a better price on the medication at a different pharmacy. She began calling around town, and was blown away when a pharmacy technician at Costco told her that a one month supply of Donepezil would cost a mere $14.87.
How is this possible?
Prescription pricing isn’t generally given the same amount of consideration as medical procedures or hospital stays, but the basic principle works the same way; insurance companies negotiate a price for services and drugs with healthcare providers and retailers. The overall cost for the service or drug is then calculated based on what providers are willing to pay, not on the actual cost.
From USA Today: “’It’s important to note that more than 97 percent of our patients do not pay cash prices,’ Walgreens spokesman Scott Goldberg told me, via email. ‘They purchase their prescriptions using some form of prescription insurance coverage.’ So, reading between the lines, the people who have insurance get a break on the cost and the people who don’t … the ones who often can’t afford insurance … are gouged?”
In a nutshell, that’s the state of healthcare in our nation today. Denying good people proper healthcare based solely on the status of their health insurance is not just morally wrong; in some cases, it is illegal. If you believe that you have been improperly denied care or received substandard care because of your insurance provider, you may be entitled to compensation.
The experienced Nashville medical malpractice attorneys at the Rocky McElhaney Law Firm can evaluate your case and help get you the compensation you deserve. For a free consultation, call 615.246.5549, visit our offices in Nashville, Hendersonville or Knoxville or contact us today.