Kill one person, go to jail. Kill thousands, get a bonus.

[quakerboy]

30. Sorta. They are still playing lots of games

Ive been helping a few neighbors do the dance.

They will be approved by insurance for one brand of insulin, not another. But they wont tell the DR in an easily accessable format which brands the insurance covers, nor the exact dose they cover. So then the dr writes the prescription based on what they see as the your medical actual needs. Then the patient goes to the pharmacy only to find out that dosage makes the bottle cover 35 days instead of 30, so the insurance doesnt cover it at the $35, and they still have to pay $105 or whatever.

So the patient gets that information, goes back for another medical visit, and they adjust the dosage to make it work. All good.. until the medicine manufacturers realize that with the new deals they dont make quite as much, so they stop making as much, or change one little thing so they can discontinue the "inexpensive" version. Now the pharmacy(and others in the area) is out of stock of the one insurance covers, so the patient gets to either do without or pay full price for a different brand or "model" that insurance doesn't cover.

Then I help them look on the marketplace to see if there's a plan that provides better coverage for the next year. And each plan covers one, or another, but none cover them all. Most of the time, there are several listings for the same drug (same name, brand, dosage, form, all details provided exactly identical), and 1 entry will be covered but another will not. How can one plan both cover and exclude the same exact insulin?