Author Topic: Dropping RX coverage - horrible idea?  (Read 2143 times)

catccc

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Dropping RX coverage - horrible idea?
« on: November 14, 2016, 02:42:16 PM »
Nobody on my family is on any type of maintenance medication.  In the last couple years, the only prescriptions filled were a couple of eye drops (pink eye), eye ointment, and antibiotics (kid had minor surgery to remove a splinter from her eyeball).  IDK what it is with eyes in my family, but whatever...

I have employer sponsored insurance and the medical and rx plans are separate elections.  The RX plan will cost me $646 for the year for my family of 4.  And that's deducted pre-tax, so it really costs me a little less than that.

Since we have historically had very little need to prescription coverage, I'm tempted to drop it.  I would never drop medical insurance, I think it is pretty important to have.  IMO it's too risky to go without.  Can the same be said about RX coverage?  Anyone have any thoughts on whether or not I should try to save $ by dropping RX coverage?

Civex

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Re: Dropping RX coverage - horrible idea?
« Reply #1 on: November 14, 2016, 05:42:06 PM »
I wouldn't risk it. All it would take is a little bad luck and you would be out serious money. If you were asking as a single, healthy person, I'd say go for it, but with four people the chances of someone needing something that would quickly eat up the $650 in savings would be too high for me.

Since you haven't needed many prescriptions, you may not realize how expensive some things are: long acting inhalers can be $250-500/month, insulin is $100s, even name brand antibiotics if someone fails the first line treatments can be ridiculous.


frugal rph

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Re: Dropping RX coverage - horrible idea?
« Reply #2 on: November 14, 2016, 06:00:53 PM »
I'm a pharmacist, and I wouldn't drop RX coverage either.  One serious illness could easily cost you more than $650 in 1 month, much less 1 year. Yes, the odds are probably that this won't happen, but I don't think it's worth the risk.

hops

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Re: Dropping RX coverage - horrible idea?
« Reply #3 on: November 14, 2016, 07:36:01 PM »
Since you haven't needed many prescriptions, you may not realize how expensive some things are: long acting inhalers can be $250-500/month, insulin is $100s, even name brand antibiotics if someone fails the first line treatments can be ridiculous.

Very true. And most of us with expensive chronic illnesses were healthy until suddenly we weren't. I'm lucky, most of my prescriptions are affordable, but there's one that costs my insurance company over $20,000 per year, which is a discounted rate.

FiguringItOut

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Re: Dropping RX coverage - horrible idea?
« Reply #4 on: November 16, 2016, 07:25:38 AM »
Please don't do it.  Especially because you have kid(s).  You just never know.

Plus Rx are very expensive without insurance and you just never know when you'll need something.
I've been on blood thinner injections (daily shots for 9 months, through two pregnancies).  These injections were $1,200 per shot.  With insurance I paid $30/month.

I've had topical cream for my daughter which was $900 for a tube.  $50 with insurance.  It was in a premium category and was the highest copay. 

Even more or less 'regular' or 'maintenance' meds that are $5-60/month with insurance can run hundreds retail.

And you have kids.  You just never know with kids.  My daughter alone used up our entire family deductible of $3500 in both 2015 and 2016.  All it took was couple trips to urgent care and one trip to emergency room between mid November 2015 and mid February 2016.  So $7K in 3 months.   

catccc

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Re: Dropping RX coverage - horrible idea?
« Reply #5 on: November 16, 2016, 07:52:54 AM »
Thanks all, I ended up keeping the prescription coverage.  When the year goes by and I've barely benefited for the nth year in a row, I'll count my blessings and move along!

My daughter alone used up our entire family deductible of $3500 in both 2015 and 2016.  All it took was couple trips to urgent care and one trip to emergency room between mid November 2015 and mid February 2016.  So $7K in 3 months.   
Is that deductible for your RX coverage specifically?!  Seems high.  I also wanted to reiterate that I would never drop medical coverage.  I'm one of those that thinks anyone going without is nuts.  I just couldn't seem to place the RX only coverage in that same arena.  Wondered if it was maybe like dental in that it is useless to some, but a huge saver for others (like me.  so much dental work...)

FiguringItOut

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Re: Dropping RX coverage - horrible idea?
« Reply #6 on: November 16, 2016, 07:55:45 AM »
Thanks all, I ended up keeping the prescription coverage.  When the year goes by and I've barely benefited for the nth year in a row, I'll count my blessings and move along!

My daughter alone used up our entire family deductible of $3500 in both 2015 and 2016.  All it took was couple trips to urgent care and one trip to emergency room between mid November 2015 and mid February 2016.  So $7K in 3 months.   
Is that deductible for your RX coverage specifically?!  Seems high.  I also wanted to reiterate that I would never drop medical coverage.  I'm one of those that thinks anyone going without is nuts.  I just couldn't seem to place the RX only coverage in that same arena.  Wondered if it was maybe like dental in that it is useless to some, but a huge saver for others (like me.  so much dental work...)

No, it's my regular medical deductible.  I used it as an example that you just never know what can happen and when you'll need coverage. 

As a side note, my Rx coverage is embedded into my medical coverage, so it's the same deductible.  Meaning all my scripts are no covered until my $3.5K deductible is met. 

Prairie Stash

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Re: Dropping RX coverage - horrible idea?
« Reply #7 on: November 16, 2016, 10:31:31 AM »
My wife dropped it when we had the chance, its for a year while my wife is on parental leave. If you drop it can you get back on it at some future time?

The extra money goes into savings. While most of this thread advocated the work premiums some of us will be retired and paying out of pocket. Eventually I hope you don't have an option either :)

catccc

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Re: Dropping RX coverage - horrible idea?
« Reply #8 on: November 16, 2016, 10:37:33 AM »
My wife dropped it when we had the chance, its for a year while my wife is on parental leave. If you drop it can you get back on it at some future time?

The extra money goes into savings. While most of this thread advocated the work premiums some of us will be retired and paying out of pocket. Eventually I hope you don't have an option either :)

I could only pick it back up if there was a life event or again at open enrollment.  Yes, I was kind of seeing this as a possibility of self insurance given savings that we have.  But I think I'm going to err on the side of caution.  I never would have considered this if it was part of medical coverage like it has typically been for me at previous employers (all 7 of them), but my current employer has it set up differently.  Interestingly, the company also self insures for this prescription benefit and dental.  They pay an administrative fee to the provider to process payments, but our company collects the premiums and pays the provider for actual benefits.  It's quite interesting.  I guess when you are big enough you have enough people like me that rarely use it, and then it's a money saving opportunity for the company.