Got some interesting emails in response to my allergies pot, one of which was a link to this story on The Consumerist about good ol' United Health Care and their aversion to paying for needed prescriptions. In this story there were no OTC or generic equivalents available, so they just refused to pay for the prescription in full.
If you read the many comments on the post you'll find that UHC isn't the only one, and that this is happening with essential prescriptions of all kinds.
Would seem to me that the potential costs from a medical emergency caused by a patient not taking their full prescription would far outstrip the costs of the prescription, but hey, what do I know?
What I do know is that insurance has always been based on the idea that we all pay, but that we don't all cost a lot, so the insurance companies make out OK.
Just take a look at UHC's 3rd quarter results [PDF]:
UNITEDHEALTH GROUP REPORTS RECORD THIRD QUARTER NET EARNINGS OF $0.79 PER SHARE • Third Quarter Revenues Rose 55% to $18 Billion • Operating Margin Reached 10.3% • Reported Operating Cash Flows were $315 Million; Adjusted Operating Cash Flows of $1.83 Billion Increased 121% (1) • Earnings Per Share Increased 30% MINNEAPOLIS (October 19, 2006) – UnitedHealth Group (NYSE: UNH) achieved record results in the third quarter of 2006. Diversified business growth was well-matched with effective cost management, advances in the integration of acquisitions and accelerating gains in profitability from seasonally strong product offerings in the third quarter, leading to a further advance in the Company’s full-year earnings outlook. UnitedHealth Group now expects full-year earnings per share growth of at least 25 percent in 2006.
Like I've said before: when are the congressional hearings?
I'm so glad to read your message. This is the same group that bought out PacifiCare/ Secure Horizons, also a "for profit" Medicare provider.
I've had Kaiser, at work then "graduated" to Kaiser Medicare.They raised rates so I went to Blue Shield. I had a doc who was not in a group, I wanted better.
Went to SCAN, a "Social HMO" (non-profit) lowest rates but the worst hospital around.
Tried Secure Horizons, the biggest available, friends like it.
If you don't have a problem, they are fine. Have an ordinary generic perscription, need a simple exam, easy blood test, no hassles. Costs a bit more, but I take good care of myself.
Then, problems! Prolonged illness, facing unavoidable hospitalization, specialized medicines, big deductions to pay, "donut hole" costs for drugs.
BUT, it's time to see what the new year changes are. Worse!
I've been biding my time checking all the plans, and what will happen now that Secure Horizons has a new owner.
I've changed back to Blue Shield, lower co-pay, no "donut hole" perscription costs, etc. A good dr. group and hospital. I'm fortunate to live where the HMO plans have lots of competition, so there are lots of choices. For now.
Planning the new doctors are willing to do the right thing, not just put me off until I'm suffering and demand help.
Posted by: Dorothy | January 03, 2007 at 06:54 PM
Wow you've been around! I hope this last option sticks for a while...as you said: it sounds good...for now.
Posted by: Elisa Camahort | January 03, 2007 at 07:26 PM