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Health Insurance, Politics, and Your 2009 Health Benefits

Where Is The Shoe Thrower When We Really Need Him?

Tomato Grower
Oaklandon Road
Wed Dec 17, 2008 7:57 AM

Post Reply

So that was fixed but what remains unfixed is the way the prescription mail order program has been changed. Recall that non-generics will take a big hit in 2009. That is understandable if there is a generic substitute for a non-generic drug and the patient opts for the non-generic instead. But it is not fair to double the cost on the non-generics where there is no generic substitute.

That's like charging double for one of those cardboard supermarket tomatoes in the winter when one of my real tomatoes is not available.

Re: Where Is The Shoe Thrower When We Really Need Him?

Analyst
IRS
Wed Dec 17, 2008 8:22 AM
I don't look forward to paying double for my husband's five name brand prescriptions. But when I consider that retail on one of them is $934 ands another is $2,200, that $65 looks like a huge bargain!

Re: Where Is The Shoe Thrower When We Really Need Him?

Retired
PO
Wed Dec 17, 2008 8:49 AM
Have to agree with the above poster. BCBS just isn't getting it. I left BC after 40 years. The reason-- premiums were way over what was reasonable and the prescription drug increase. NALC is a great insurance and I don't know why I havn't changed before. I hope BC and OPM takes a good long look at their actions after this season is over.

I am not surprised to get screwed by BCBS , but I thought OPM was supposed to be watching out for me. Surprise, surprise, they are in bed together.

Re: Where Is The Shoe Thrower When We Really Need Him?

worker
government
Wed Dec 17, 2008 9:25 AM
I agree that if there is no generic substitute, it is not fair. Howev er, the cost of the brand name drugs is so horrendous, that it is necessary to raise the prices. This I am assuming, but you can check it against your billing statement.
One thing that could be done is to force the health benefit providers to negotiate prices with the drug companies. This could force a reduction of prices.

Re: Where Is The Shoe Thrower When We Really Need Him?

IT Specialist
USDA
Wed Dec 17, 2008 9:45 AM
They MAKE the drug prices ridiculous. My husband was traveling overseas & got his Lipitor for $8. Why should we pay $65 here?? Also, this week we got a BCBS mailing on sweitching to generics - "ask your doctor to switch you to Crestor, the generic for Lipitor". Our doctor said they are not the same & wouldn't do it. I beleive the doctor over the insurance and drug complanies any day.

Re: Where Is The Shoe Thrower When We Really Need Him?

Diversity Manager
DOL
Wed Dec 17, 2008 7:21 PM
There isn't another insurance plan in the private sector that allows customer to choose non generics. Most plans stipulate that you must use generics except the Feds. This is what drives up premium costs, there should be no option!!

Re: Where Is The Shoe Thrower When We Really Need Him?

Reformed Conservative
DFAS
Thu Dec 18, 2008 8:22 AM
Hello IT Specialist,

All first-world countries except the U.S. cap prescription drug prices, so that drug companies cannot rob patients as they do here. I've been writing my Congressman for years suggesting that he introduce a bill for us to do the same, but all I ever get back is a form letter in response.

Blue Cross

Reformed Conservative
DFAS
Wed Dec 17, 2008 8:28 AM

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Thanks, Ralph!

This is a good example of why we should always be careful to read the fine print, even if we don't think anything has changed. Blue Cross almost got away with this.

SO why is it only BC getting scrutiny?

IT Drone
DoD
Wed Dec 17, 2008 8:33 AM

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Many of the other federal insurance plans added obscenely high deductibles--even when using IN NETWORK services.

In one plan, non-generic prescriptions (and not only for mail order) went from a fixed rate to a percentage of the negotiated rate with a high minimum and a higher maximum. Problem is, the policy holder does not have access to that negotiated rate chart so we don't know if we are being charged properly or if the pharmacy is padding the prices.

Insurance is the only benefit left and it seems the outgoing administration is taking it away as punishment because their side lost.

BCBS is Pure BS

Analyst
State
Wed Dec 17, 2008 8:38 AM

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After 20 years with BCBS, I have decided to take my business elsewhere. Its sneaky approach in changing benefits and overall shabby treatment of customers cannot be overlooked. I most other federal employees will send a message to BS by enrolling in other health plans.

Re: BCBS is Pure BS

Worker Bee
DOJ
Wed Dec 17, 2008 11:20 AM
I switched from BCBS years ago after they refused to pay bills related to complications arising from the birth of my child. They claimed that the emergency, life-saving procedures were not "medically necessary." After losing, they then denied the charges claiming they were above the usual and customary costs, but they refused to reveal what the usual and customary costs should be. During lawsuit discovery processes, I learned that the customary costs were basically whatever BCBS wanted to say those costs should be and varied from procedure and patient to procedure and patient. Another problem: one day I received a HUGE packet of mail from BCBS which included many unprocessed claims for a number (more than 30) of insureds. These forms included ssns, names, dobs, personal medical info of all these people. With shenanigans like that, how comfortable should one be with BCBS? Also, before signing up with BCBS, check w/ your drs. Many (here in TX) have stopped accepting BCBS.

Health Insurance

Proc Analyst
USDA
Wed Dec 17, 2008 8:38 AM

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After considering BCBS's changes to generic prescription drug coverage, and proposed changes to the non-participating provider surgery coverage, I did the research and switched to the Letter Carrier Plan (NALC) which is underwritten by Cigna. Friends who've had this plan for years swear by it and I saved $360 right off the top.

I say, good riddance BC/BS!

Blue Cross Changes

Training Officer
DoD
Wed Dec 17, 2008 8:40 AM

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Looks like we'd still better grill the emergency room doctor before we let him set that broken leg or treat that stroke!

what about med prices?

RN
Dept of VA
Wed Dec 17, 2008 8:43 AM

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Thanks to the "plansmartchoice" tool (for plan comparisons) that is available for most federal employees my wife (also a Fed employee) and I were able to select a plan that better suited our family. Our initial reason for taking a closer look at the alternatives was the increase (almost DOUBLE) in cost for 90day supply name brand meds through the "Standard" plan for 2009- but everyone in the Standard option plan must not mind this dramatic cost increase since it has been totally forgotten due to the proposed surgery cost increase.

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