I have a high deductible plan with a $1400 deductible and a HSA I use for medical expenses.
I actually have great insurance but haven’t been on this plan very long as I changed jobs midway through last year and am not super familiar with all the ins and outs. Prior to this ive only had super shitty insurance so I’m used to crazy high pricing and doing work around to get meds and visits more affordable.
I needed new epi pens/ auvi-q epinephrine injectors as mine expired and they are mandatory to continue my allergy shots. With my prior insurance, auvi-q was way cheaper and I owed maybe $30. This time they told me they covered the difference with copay assistance and not to worry. I didn’t bother checking to see the price of the epi-pens as they were free.
During this time I’ve also been checking my insurance claims pretty regularly as my allergist just got bought out and there have been some billing discrepancies. I go weekly for shots, and have had 7 other visits to the ENT this year already so there are lots of payments to verify. Today I logged in and it says I’ve hit my deductible for the year. I was at $250 last week and now it says I’ve spent the entire $1400 out of pocket. When I looked into it, it looks like the copay assistance for the auvi-q was for OVER $1000. Insurance only covered $50 over my deductible nothing else.
If auvi-q was a normal drug you get from the pharmacy this would have easily been caught and I could have switched to something covered by my insurance. But the entire process is handled by my doctor and then the company calls you and tells you what you owe and takes your shipping address. I haven’t received my injectors yet and also have no paperwork or anything regarding this insane price. I looked after the fact, and my insurance does cover the injectors, just not Auvi-a and my copay should have been $10.
Since I didn’t pay this money obviously, I feel like it shouldn’t be counting towards my deductible. I clearly don’t want to commit any insurance fraud but I’m not quite sure if I’ve done anything wrong here. I’m scheduled to have quite a few tests run this year already and had committed to hitting my deductible. Should I be flagging this to someone? Is this illegal? Is there anything I should do on my side? I’m happy to take my “free” money but it feels very ethically and morally wrong tbh which has got me concerned. Additionally I feel really slimy taking copay assistance from someone who might legitimately need it when I can literally get the same drug for $10.
submitted by /u/meowmeowroar
[link] [comments]
I have a high deductible plan with a $1400 deductible and a HSA I use for medical expenses. I actually have great insurance but haven’t been on this plan very long as I changed jobs midway through last year and am not super familiar with all the ins and outs. Prior to this ive only had super shitty insurance so I’m used to crazy high pricing and doing work around to get meds and visits more affordable. I needed new epi pens/ auvi-q epinephrine injectors as mine expired and they are mandatory to continue my allergy shots. With my prior insurance, auvi-q was way cheaper and I owed maybe $30. This time they told me they covered the difference with copay assistance and not to worry. I didn’t bother checking to see the price of the epi-pens as they were free. During this time I’ve also been checking my insurance claims pretty regularly as my allergist just got bought out and there have been some billing discrepancies. I go weekly for shots, and have had 7 other visits to the ENT this year already so there are lots of payments to verify. Today I logged in and it says I’ve hit my deductible for the year. I was at $250 last week and now it says I’ve spent the entire $1400 out of pocket. When I looked into it, it looks like the copay assistance for the auvi-q was for OVER $1000. Insurance only covered $50 over my deductible nothing else. If auvi-q was a normal drug you get from the pharmacy this would have easily been caught and I could have switched to something covered by my insurance. But the entire process is handled by my doctor and then the company calls you and tells you what you owe and takes your shipping address. I haven’t received my injectors yet and also have no paperwork or anything regarding this insane price. I looked after the fact, and my insurance does cover the injectors, just not Auvi-a and my copay should have been $10. Since I didn’t pay this money obviously, I feel like it shouldn’t be counting towards my deductible. I clearly don’t want to commit any insurance fraud but I’m not quite sure if I’ve done anything wrong here. I’m scheduled to have quite a few tests run this year already and had committed to hitting my deductible. Should I be flagging this to someone? Is this illegal? Is there anything I should do on my side? I’m happy to take my “free” money but it feels very ethically and morally wrong tbh which has got me concerned. Additionally I feel really slimy taking copay assistance from someone who might legitimately need it when I can literally get the same drug for $10.
submitted by /u/meowmeowroar [link] [comments]Read Morer/HealthInsurance