Is different in every State. Here the insurer is Florida Blue, a seperate part of Blue Cross and Blue Sheild. I think you maybe using the wrong word. The deductible is high. That is the amount you must pay, starting at the beginning of the calender year, for the insurence to start covering anything. I suppose your deductible is $500. Not sure what Florida Blue's is but when my dad was trying to get my step mom on it, it was so high he opted to not take it out as it was cheaper to just not be insured. I believe that also had to do with the fact that they don"t cover much.
I am on group insurence but it is a forced health savings plan, just like my last one. There is a $1,500 deductible at the beginning of the year. The company pays the first $750 and then I pay the next $750 and then they start covering at 90% until I hit a $3500 out of pocket max and then they cover 100% (except for things like specialists where a co-insurence starts to pick up). During my part of the $750 all doctor visits and prescriptions are full retail cost. Nothing is covered by insurence (though must be ran through the insurence) until I hit $750.
A co-pay is how much you pay at a doctor visit. Like at my therapist it was a $10 co-pay every week but that was a PPO. I miss PPOs. Also medications have their own different co-pays. Usually something like $10 for generics.
To me, this sounds like a dedictible that started due to the new calender year. An insurence can tell you that you must fill a prescription with them for them to cover it. Like many of my medications (like gabepintin) was forced mail order with Opum Rx on my last insurence and express scripts on this one for them to cover it. But I could tell a pharmacy (any pharmacy) to fill it at retail. Meaning they don't run it through the insurence and instead charges you whatever the retail price is. This is where Good Rx:
Dead Link Removed and manufactor coupons come in handy. The manufactor coupons would need to be brand name and my pharmacy won't fill brand name unless it says "brand name medically necessary" is on the script unless there isn't a generic but I have been able to get some anti-depressants for like very cheap and even one was for free this way. My PDoc gave me the manufactor coupon when she wrote the script. This was during the time of the anti-depressent merry-go-round. But, if you do this, it will not count toward your deductible thus all the money you are spending doesn't go towards that $500 so I'd use that sparingly. The thing is, though, most medications aren't that expensive. Especially generic. The only 2 exceptions I have found for that is seriquel xr which is over $300 generic and fentyal patches (which my insurence would only cover brand name) and I believe that was close to $200. But Xanax, for example, is $14 full retai generic. So that is likely why you are seeing that you must fill prescriptions with the insurence and in that case the coupons may not work but it would be worth calling the insurence pharmacy and see if they take prescription savings cards and manufactor coupons. They normally work like a regular phamacy so I don't see why not as they are still getting the money from the manufactor. But if you must taper for a month or two go retail with it and just not count it towards the $500. I've had to do that a time or two.
Another thought. A deductable does not get paid all at once. You pay it off with whatever the Dr visits and prescriptions are at retail with no insurence. My therapist is $125 but my pain Dr is over $300. One medication is $14 and another over $300. So you are paying it off over time and not spending the entire $500 at once.
Anyway, I hope this helps some. Sorry you are in this pickle but for one that has to pay $750 of my $1500 deductible, I feel your pain.
